How did you hear about Peak Prime Health?Friend ReferralGoogleSocial MediaAdsHow difficult is it for you to delay ejaculation? *The IIEF-5 survey is an international standards for assessing ED severityHow difficult is it for you to delay ejaculation?1 Never or almost never2345 Always or almost alwaysHow difficult is it for you to delay ejaculation? *The IIEF-5 survey is an international standards for assessing ED severityHow difficult is it for you to delay ejaculation?1 Never or almost never2345 Always or almost alwaysDo you ejaculate with very little simulation? *The IIEF-5 survey is an international standards for assessing ED severityDo you ejaculate with very little simulation?1 Never or almost never2345 Always or almost alwaysDo you feel frustrated because of ejaculating before you want to? *The IIEF-5 survey is an international standards for assessing ED severityDo you feel frustrated because of ejaculating before you want to?1 Never or almost never2345 Always or almost alwaysHow concerned are you that your time to ejaculation leaves your partner sexually unfulfilled? *The IIEF-5 survey is an international standards for assessing ED severityHow concerned are you that your time to ejaculation leaves your partner sexually unfulfilled?1 Never or almost never2345 Always or almost alwaysDo you have any issues sustaining an erection? *Note: Concomitant ED is a possible cause of premature ejaculationDo you have any issues sustaining an erection?YesNoDo you take any of the following medications? *1)Mood stablizers/ Anti-depressants/ Anti-psychotics 2)MAOIs - eg. Linezolid, methylene blue 3)Pimozide 4) DisulifiramDo you take any of the following medications?YesNoDo you have any history of mental health disorder / suicidal though? *If you have of these, oral premature ejaculation treatment may not be suitable for you. Our doctor may ask you more question to understand your circumstances.Do you have any history of mental health disorder / suicidal though?YesNoDo you have any known drug allergies? *Do you have any known drug allergies?YesNokindly state what medication you are allergic. Please describe. *Username *Email *Password *Proceed
