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@if (isset(session()->get('doctor')['vCentralCode']))

Name of Doctor *

@else

Name of Doctor *

@endif

Age (years) *

<30

30-40

41-50

51-60

>60

Degree/Qualification*

Place of Practice *

Tier 1

Tier 2

Tier 3

Clinical experience in managing patients with sexual dysfunction *

<5 years

5-10 years

11-20 years

>20 years

Incidence and proportion of Sexual dysfunction cases

On an average how many male patients with sexual dysfunction do you come across every month in your clinical practice? *

1-5

6-10

10-15

16-20

>20

Out of the total male sexual dysfunction cases you see in your practice, what percentage do the following conditions represent? *

(Please ensure total adds up to 100%)

Type of sexual dysfunction	Percentage of patient
Erectile dysfunction	%
Premature ejaculation	%
Erectile dysfunction with premature ejaculation	%
Low libido	%

Please mention the three most frequent associated comorbidity with the following conditions *

	Co-morbid condition 1	Co-morbid condition 2	Co-morbid condition 3
Premature Ejaculation
Erectile Dysfunction
Decreased Libido

Practice in treating Erectile dysfunction

What is your most preferred PDE5 inhibitor for managing erectile dysfunction? *

Sildenafil

Tadalafil

Vardenafil

Avanafil

What are your primary selection criteria for choosing a specific PDE5 inhibitor to treat erectile dysfunction? (Select up to 3) *

Efficacy

Onset of action

Duration of effect

Side effect profile

Patient preference

Cost

Comorbid conditions

Availability of lower dose or on-demand options

Other

Please rate the following PDE5 inhibitor based on your experience in terms of efficacy, safety, and tolerability (rate each on a scale of 1 to 5, with 1 being the lowest and 5 being the highest) *

Sildenafil
Efficacy	1	2	3	4	5
Safety	1	2	3	4	5
Tolerability	1	2	3	4	5

Tadalafil
Efficacy	1	2	3	4	5
Safety	1	2	3	4	5
Tolerability	1	2	3	4	5

Vardenafil
Efficacy	1	2	3	4	5
Safety	1	2	3	4	5
Tolerability	1	2	3	4	5

Avanafil
Efficacy	1	2	3	4	5
Safety	1	2	3	4	5
Tolerability	1	2	3	4	5

If Tadalafil is selected as the most preferred PDE5 inhibitor then which is the preferred dosing schedule in your clinical practice *

Tadalafil 5mg (Daily Dosing)

Tadalafil 5mg (On-Demand)

Tadalafil 10mg (On-Demand)

Tadalafil 20mg (On-Demand)

Practice in treating Premature Ejaculation

What is your preferred formulation, in the treatment of Premature Ejaculation? *

Oral

Topical

Kindly list down specific reasons for the above preferred formulation *

Practice in treating decreased libido

What is your preferred testosterone formulation in the treatment of low Libido? *

Capsules

Gel

Depot

Please specify reason for usage against each formulation *

Capsule	Gel	Depot

In patients with Low Libido, which is the preferred testosterone supplementation in your clinical practice? *

Testosterone undeconate

Testosterone propionate

Testosterone enanthate

Please specify duration of usage of Testosterone supplementation in your clinical practice *

1 month

3 months

6 months

9 months

Other

What are the primary challenges you face in the management of male sexual dysfunction? *

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Clinical practice and preferences in management of male sexual dysfunction: A survey on erectile dysfunction, premature ejaculation and low libido

Survey Questionnaire Form

Details of treating physician

Incidence and proportion of Sexual dysfunction cases

Practice in treating Erectile dysfunction

Practice in treating Premature Ejaculation

Practice in treating decreased libido