MARKET RESEARCH – Project Erectile Dysfunction

We are looking for males who suffer from erectile dysfunction to take part in an interview in London for 75 minutes.

LOCATION:		London WC2
DATE:		Dates vary from 12th June – 19th June 2017
INCENTIVE:		£70.00
TIME:		Various times available from 9.30am – 9pm

Please answer the questions below.

Name:

Telephone number:

Home Postcode:

Work Postcode:

Age:

Who do you live with at home?

Occupation:

Job Title:

Working status i.e. Student, Full time working, part time working, etc.

Which of the following do you suffer from?

Low testosterone
Weight issues
Prostate issue
Problems getting/maintaining an erection
Sexual health

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

Which of the following have you suffered with in the last 6 months?

Prostate issues
Premature ejaculation
Sexual health
Herpes
Difficulty maintaining or getting an erection
Anxiety
Depression
Reduced Libido/sex drive

Which of the statements do you agree with?

Sexual health is an important part of an individual’s overall well-being
Sexual health is an important component to a healthy relationship
None of the above

Which prescription medications do you currently take for ED?

Which prescription medications have you ever taken for ED?

Which prescription medications have you taken in the last 3 months for ED?

Which over the counter medications are you currently taking for ED?

Which over the counter medications have you ever taken for ED?

Which over the counter medications have you taken in the last 3 months?

Have you ever discussed the ED issues with a healthcare professional? Yes/No?

Habe 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