What best describes your current concern?

Decreased sensitivity or sensation

Difficulty with performance or arousal

Changes in function with age

General interest in improving wellness

No major concern, just curious

How long have you noticed changes?

Over a year

6–12 months

Less than 6 months

I haven’t noticed changes

Has this had any effect on your confidence or relationships?

Yes — it’s caused real frustration or stress

Somewhat — I notice it, but I manage it

Not really — it hasn’t had much impact

Have you tried anything to improve your situation?

Supplements or over-the-counter aids

Medication (e.g. pills, prescriptions)

Lifestyle or behavioral changes

No — I haven’t tried anything yet

Which age range are you in?

Under 35

35-50

Over 50

How open are you to non-surgical regenerative therapy?

Very open — I’m actively researching it

Open — but I’d like more information

Unsure — I’m just exploring

What would you hope to improve most?

Increased sensation or function

Better connection or confidence

Preventative / long-term wellness

Not sure yet

If this was a good fit for you, what would you want to do next?

Speak with someone and learn more

Ask some questions and review options

Wait and think about it for now

How motivated are you to find a solution for this?

Very motivated — I want to resolve this

Somewhat — I’m weighing my options

Not in a rush — just exploring

Has this concern affected how you feel about yourself?

Yes — it’s had a noticeable emotional impact

Slightly — it’s something I’m aware of

No — I don’t feel affected

When would you ideally like to improve this issue?

As soon as possible

In the near future

I’m not in a rush

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