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2011
October
E
ED Survey
ED Survey
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What age group do you belong to?
21 to 30
31 to 40
41 to 50
51 to 60
61 to 70
70 to 80
What is your frequency of usage of Erectile Dysfunction drug?
Every day
As needed
Once a week
Other
Which ED drugs have you used in the past (Select all that apply)?
Viagra
Cialis
Levitra
Other
Which Erectile Dysfunction drug do you prefer?
Viagra
Cialis
Levitra
Other
Does the spouse have influence over your preference?
Yes
No
What is the reasoning for her preference?
Does the doctor have influence on your preference?
Yes
No
What is the doctor's reasoning for the recommendation of the particular brand?
Please rank the below attributes of ED drug in order of importance according to you ("1" is most important and "7" is least important)
Time for onset of erection
-- Select --
1
2
3
4
5
6
7
Lasting time of the effect of drug
-- Select --
1
2
3
4
5
6
7
Strength of erection
-- Select --
1
2
3
4
5
6
7
Side effects
-- Select --
1
2
3
4
5
6
7
Waiting time after eating to take the drug
-- Select --
1
2
3
4
5
6
7
Cost of drug
-- Select --
1
2
3
4
5
6
7
Be able to take drug as required Versus having to take it everyday
-- Select --
1
2
3
4
5
6
7
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