Name
Phone
Email Address
1. Have you ever actually measured your own or someone else's penis?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
2. Have you ever attempted to seduce / allowed yourself to be seduced by someone?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
3. Have you ever been a foot fetishist to any degree?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
4. Have you ever been a voyeur?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
5. Have you ever been arrested (picture taken and all)?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
6. Have you ever been decidedly bisexual?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
7. Have you ever been decidedly heterosexual?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
8. Have you ever been decidedly homosexual?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
9. Have you ever been in a menage-a-trois (mfm or fmf)?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
10. Have you ever been in contact with more than one person while all were nude?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
11. Have you ever been injured during sex?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
12. Have you ever been propositioned for group sex?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
13. Have you ever been to a (cooking, baby, wesson) oil party?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
14. Have you ever been to a peep show?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
15. Have you ever bought and used controlled/illicit drugs in violation of the
law?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
16. Have you ever bought/read books to enhance sexual technique?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
17. Have you ever broken your word, promise, or vow?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
18. Have you ever deliberately injured yourself so as to obtain medication?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
19. Have you ever exaggerated about any sexual experiences?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
20. Have you ever fantasized about your teacher/lawyer/doctor/nurse/psychiatrist?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
21. Have you ever french kissed?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
22. Have you ever given a back or neck rub or massage with no ulterior motive?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
23. Have you ever given a massage with ulterior motives?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
24. Have you ever gone skinny dipping alone or with others?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
25. Have you ever gone steady?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
26. Have you ever gone to a motel for the sole purpose of having sex?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
27. Have you ever gone to class or work while under the influence of drugs?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
28. Have you ever had a date?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
29. Have you ever had an alcoholic drink and/or been intoxicated?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
30. Have you ever had an arousing dream (wet dreams and the like?) Or sexually
aroused?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
31. Have you ever had an orgasm?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
32. Have you ever had nude pictures of you taken?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
33. Have you ever had sex?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
34. Have you ever had sex doggie fashion or sitting up or standing up or upside
down?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
35. Have you ever had sex in a household room other than a bedroom?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
36. Have you ever had sex in a place where you could have been discovered?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
37. Have you ever had sex in a place with the ambient temperature below freezing?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
38. Have you ever had sex in a suspension device of some kind (hammock)?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
39. Have you ever had sex in an elevator, people-mover, escalator, dumbwaiter?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
40. Have you ever had sex in front of or under a mirror?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
41. Have you ever had sex in/on a construction site (house, office, etc?)?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
42. Have you ever had sex on the beach?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
43. Have you ever had sex on the first date?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
44. Have you ever had sex on the floor (but not the roof)?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
45. Have you ever had sex while under the influence of ecstasy/x?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
46. Have you ever had sex while under the influence of marijuana/sensemilia?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
47. Have you ever had sex while under the influence with a unknowing partner?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
48. Have you ever had sex with a virgin (not yourself?)?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
49. Have you ever had sex with both genders in a 24 hour period?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
50. Have you ever had sex with more than 1 person in a 24 hour period?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
51. Have you ever had sex with more than 10 people (not necessarily at one time)?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
52. Have you ever had sex with someone not of your own race?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
53. Have you ever had sex with someone whose name you did not know?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
54. Have you ever had sex with someone whose name you didn't know / face you
never saw?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
55. Have you ever had sex with someone with a 20 year age difference?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
56. Have you ever had your feet and/or toes licked or sucked by someone else?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
57. Have you ever held hands or otherwise displayed public affection?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
58. Have you ever held hands with someone?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
59. Have you ever kissed / french kissed someone on the lips?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
60. Have you ever kissed a friend or stranger as a friendly gesture?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
61. Have you ever lied ?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
62. Have you ever listened to dirty jokes in mixed company?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
63. Have you ever made an x- or r-rated snowman or snowwoman?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
64. Have you ever made obscene phone calls?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
65. Have you ever necked?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
66. Have you ever owned an underwear collection of underwear not belonging to
you?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
67. Have you ever petted?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
68. Have you ever petted above or below the waste?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
69. Have you ever petted in a water/wind or prop driven transport medium?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
70. Have you ever phoned up any recorded phone sex numbers?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
71. Have you ever physically watched others having sex?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
72. Have you ever picked someone up or been picked up?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
73. Have you ever pierced a part of your body other than your ears or nose?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
74. Have you ever placed / answered a personal ad?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
75. Have you ever plagiarized?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
76. Have you ever played naked twister [tm] (with or without oil)?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
77. Have you ever practiced bondage / domination / submission?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
78. Have you ever practiced role-playing?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
79. Have you ever practiced transvesticism?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
80. Have you ever read or bought pornographic periodicals?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
81. Have you ever received / given a hickey?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
82. Have you ever received an enema for a purpose other than medical?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
83. Have you ever secretly lusted after someone without that person knowing?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
84. Have you ever shared a bed with someone without anything steamy happening?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
85. Have you ever shaved someone's pubic hair (or had yours) as part of sex?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
86. Have you ever shoplifted?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
87. Have you ever slow danced?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
88. Have you ever smoked tobacco (cigarette/pipe/cigar/hookah/snuff)?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
89. Have you ever stolen anything?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
90. Have you ever stroked or fondled someone?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
91. Have you ever stuffed your bra or stuffed your pants?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
92. Have you ever taken valium?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
93. Have you ever told dirty jokes in mixed company?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
94. Have you ever told someone that you loved them just for sex?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
95. Have you ever used a penis as a leash or bludgeoning device?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
96. Have you ever used a commercial aphrodisiac?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
97. Have you ever used a feather or other device for the purpose of tickling?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
98. Have you ever used hot/melted wax for sexual purposes?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
99. Have you ever used ice for sexual purposes?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
100. Have you ever used tickling as a form of *arousal*?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
101. Have you ever uttered/muttered/yelled/screamed obscenities?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
102. Have you ever watched a porn movie in mixed company?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
103. Have you ever willingly made video tapes or pictures taken while having
sex?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
104. Have you ever worn / eaten edible underwear/lingerie?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
105. Have you ever worn groinal underwear on your head (panties/jock-strap/etc?)?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
106. Have you ever written anonymous 'love letters' to someone?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable
107. Have you ever written graffitti?
--Make a choice--
Yes
No
No but would like to
Refuse to answer
Not applicable