MARKET RESEARCH – Project Erectile Dysfunction

We are looking for males aged 40-70 who suffer with Erectile Dysfunction to take part in a group discussion in London for 3 hours.

Please answer the questions below.

Name:

Telephone number:

Postcode:

Age:

Highest level of education achieved?

Occupation:

Job Title:

Working Status:

Occupation of chief income earner in the household?

Who do you live with in your household?

Which one of the following descriptions do you most closely identify yourself?

• Heterosexual
• Bisexual
• Homosexual

Have you been sexually active in the last 6 months? Yes/No?

Have you suffered from erectile dysfunction (difficulty getting or maintaining an erection) in the last 6 months? Yes/No?

Which, if any, medication/s are you currently taking to help treat your erectile dysfunction?

Which, if any, medication/s have you taken in the past but are not currently taking any more for your erectile dysfunction?

How satisfied are you with the current medication you are taking for your erectile dysfunction?

Have you discussed your condition with a healthcare professional? Yes/No?

Do you currently use any of the following medications?

• Isosorbide tablets
• Nitroglycerin tablets
• Oral spray
• Skin patches

Have you had surgery to remove your prostate? Yes/No?

Please forward this on to anyone you know who may be interested.
 

Unfortunately, it is impossible to reply to all emails or phone messages.   We receive lots of responses to researches that are emailed out. You will be contacted by phone if your application is successful. However, we apologise if you do not hear from us, but please keep trying for future projects that are sent out.

We look forward to hearing from you.
 
Kind regards,
 
 
Daliah Salem
trend MARKET RESEARCH LTD