Greensboro SHIM Form

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How do you rate your confidence that you could get and keep an erection? How do you rate your confidence that you could get and keep an erection?1 - Very low2 - Low3 - Moderate4 - High5 - Very High

When you had erections with sexual stimulation, how often were your erections hard enough for penetration? When you had erections with sexual stimulation, how often were your erections hard enough for penetration?1 - Almost never or never2 - A few times (much less than half the time)3 - Sometimes (about half the time)4 - Most times (much more than half)5 - Almost always or always

During sexual intercourse, how often were you able to maintain your erection after you had penetrated your partner? During sexual intercourse, how often were you able to maintain your erection after you had penetrated your partner?1 - Almost never or never2 - A few times (much less than half the time)3 - Sometimes (about half the time)4 - Most times (much more than half)5 - Almost always or always

During sexual intercourse, how difficult was it to maintain your erection to completion of intercourse? During sexual intercourse, how difficult was it to maintain your erection to completion of intercourse?1 - Extremely difficult2 - Very difficult3 - Difficult4 - Slightly difficult5 - Not difficult

When you attempted sexual intercourse, how often was it satisfactory for you? When you attempted sexual intercourse, how often was it satisfactory for you?1 - Almost never or never2 - A few times (much less than half the time)3 - Sometimes (about half the time)4 - Most times (much more than half)5 - Almost always or always

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