Questionnaire

Age

What is your gender identification and sexual identification? (IE: monogamous, polyamorous, other)

Occupation:

How would you describe your childhood?

Did you grow up in a restricted religious home? If yes, please elaborate.

What were the messages you received around sexuality as a child?

Where do you currently live?

If you are not in the Austin area would you be willing to fly here for a VIP day or weekend?

How would you describe your state of health? Are you satisfied with it?

Have you ever had any serious health issues, surgeries, or injuries? Please explain.

What is your current relationship status?

How many long-term relationships have you had?

Do you have children or want children? Please list ages.

If partnered, is your partner supportive? Is she/he/they willing to treat this as a couple’s issues?

Share anything else about your current partnership that feels relevant to your success and working with me.

Do your sexual experiences include intimacy, pleasuring, eroticism, arousal, intercourse and afterplay?

How often do you have sex or masturbate?

How often do you ejaculate?

How long does masturbation last?

During masturbation do you use porn? If so, how frequently? How long have you been using porn as an arousal aid?

If partnered, is there a genuine bond of trust, intimacy, respect and a desire for a sexually satisfying relationship? Would you describe your partner as an intimate ally?

Have you and your partner, or previous partner, experienced or are currently experiencing unresolved emotional conflicts, profound discomfort with intimacy, or distresses such as mistrust in response to infidelity?

What is your super power in relationship?

What is your biggest challenge in relationship?

If partnered, do you agree on the frequency of sex? How long does sex last?

How often would you like to have sex?

Have you experienced abandonment, rejection, blaming, or criticism with a partner? Please explain?

Have you sought sex therapy or counseling in the past? What for? What was the outcome? Did your partner participate?

Did you learn erotic techniques? If yes, please share.

Did you learn ejaculation control techniques? If so, please elaborate?

If you are experiencing PE or ED when did it begin?

Have you been to a urologist or medical doctor about this issue? If so, what was the diagnosis? Were you prescribed medication?

Have you ever had any urological issues or prostatitis (prostate infection?) If so when?

Have you ever been diagnosed with a psychological disorder such as, bipolar mood disorder or manic depressive, generalized anxiety disorder, avoidant personality disorder, chronic depression, schizophrenia, personality disorder, borderline disorder, post-traumatic stress disorder or experienced any chronic unresolved personal issues?

Have you ever sought treatment for drug abuse or alcoholism?

Have you ever been on, or are you currently on opiates or tranquilizers?

Are you on any medications? Please list.

Do you use over-the-counter cold medication like Sudafed (pseudoephedrine)?

Have you ever been a victim of a violent crime or experienced sexual trauma or abuse? And if so, have you ever sought treatment? If yes, do you feel that it was helpful? Please elaborate.

What do you require to feel sexually and emotionally satisfied? Must you ejaculate?

When sex goes poorly, either in your current relationship or past relationships, how do you handle it?

How long have you experienced your current challenge? Please elaborate.

How would you describe yourself as a lover?

On a scale of 1-10 with 10 equaling I’m always aroused and 1 equating I never or rarely experience sexual desire how would you rate yourself?

What are your ultimate sexual goals and desires?

What is your typical diet? Standard American Diet, Paleo, Keto, Vegan, Vegetarian. Describe your typical meals for one day? Do you watch what you eat?

Do you drink caffeine or alcohol? How much.

Are you on any supplements?

Rate yourself on a scale of 1-10 with 1 equaling I detest my body, and 10 equating I LOVE my physique and wouldn’t change a thing.

What is your exercise of choice? How often do you exercise?

How would you rate yourself on a scale of 1-10 with 1 equaling no stress and 10 equaling always under extreme stress? If over 5 can you pinpoint the cause?

Are you dealing with the death of a loved one, ongoing occupational stress, divorce, or chronic illness, situational anxiety?

Do you have a spiritual practice?

Do you meditate or practice mindfulness?

Rate yourself on a scale of 1 to 10 with 10 equating my penis is perfect and 1 equating I hate my penis and I’m extremely embarrassed about its shape or size.

How committed are you to your sexual mastery and adhering to this coaching program?

What do you foresee as challenges in adhering to homeplay and protocols and completing this coaching program?

Are you willing to devote time, energy and discipline to the program?

What haven’t I asked that you wish I had?

What else do you think is important for me to know?

Sexual Mastery Questionnaire

Please complete the questionnaire below

Enter the temple and step into bliss

Questionnaire

Sexual Mastery Questionnaire

Please complete the questionnaire below