Are You a Candidate for
the EDGEProcedure™?

Complete this questionnaire and our doctor will review your responses and contact you to discuss your potential treatment options.


1. Over the last month, how often were you able to get an erection during sexual activity?
This field is required.
2. Over the last month, when you had erections with sexual stimulation, how often were your erections hard enough for penetration?
This field is required.
3. Over the last month, when you attempted intercourse, how often were you able to penetrate your partner?
This field is required.
4. Over the last month, during sexual intercourse, how often were you able to maintain your erection after you had penetrated your partner?
This field is required.
5. Over the last month, during sexual intercourse, how difficult was it to maintain your erection to completion of intercourse?
This field is required.
6. Over the last month, how do you rate your confidence that you can get and keep your erection?
This field is required.
This field is required.
This field is required.
This field is required.

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