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Premature Ejaculation Assessment

The following questionnaire is designed to assess whether you may be experiencing premature ejaculation. It is based on the validated Premature Ejaculation Diagnostic Tool (PEDT) and helps identify whether premature ejaculation may be affecting you.
Please answer each question as honestly as possible. Your responses will provide an indication of your erectile function and can help inform a discussion with one of our clinicians if you choose to book a consultation.
The questionnaire takes approximately 1–2 minutes to complete.
Please note: for the purpose of this questionnaire, "ejaculation" refers to the release of semen after penetration (i.e. once your penis has entered your partner).

Full Name

Email Address

Date of Birth

I understand that my responses will be securely stored and may be used by my clinician if I choose to book a consultation.

A