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Ulta Boost V
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General Health Screening
Do you have any diagnosed heart conditions? *
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Are you currently taking any nitrates or medications for chest pain? *
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Have you been diagnosed with low blood pressure or uncontrolled high blood pressure? *
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Are you currently taking any medications for erectile dysfunction or have you in the past? *
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Do you experience chest pain, fainting, or severe dizziness during sexual activity? *
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What medications or supplements are you currently taking? *
Are you able to engage in mild to moderate physical activity without discomfort? *
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ED Specific Questions
How long have you experienced erectile difficulties? *
Are your difficulties occasional or consistent? *
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Do you have morning erections? *
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Are you currently satisfied with your sexual performance? *
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Have you been diagnosed with any conditions that may contribute to ED, such as diabetes or depression? *
Have you tried any treatments for erectile dysfunction before? *
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