16 Broadway, Rainham, Essex, RM13 9YW

The International Index of Erectile Function

Patient Questionnaire

These questions ask about the effects that your erection problems have had on your sex life over the last four weeks. Please try to answer the questions as honestly and as clearly as you are able. Your answers will help us to choose the most effective treatment suited to your condition. In answering the questions, the following definitions apply:

– sexual activity includes intercourse, caressing, foreplay & masturbation
– sexual intercourse is defined as sexual penetration of your partner
– sexual stimulation includes situation such as foreplay, erotic pictures etc.
– ejaculation is the ejection of semen from the penis (or the feeling of this)
– orgasm is the fulfilment or climax following sexual stimulation or intercourse


The result of your assessment can be received after submission through a telephone consultation or an in- clinic face-to-face consultation.

Telephone consultation will be 15-minute and costs £30 while a face-to-face consultation is 30-minutes and costs £60

You can pay a deposit of £100 towards your shockwave or P-Shot treatments.