Essential Men's Clinic
  • Home
  • Priapus Shot®
    • P-Shot® Research Articles Papers >
      • Is the P-Shot FDA Approved - Essential Mens Clinic
      • P-Shot® Data Information
    • P Long® Protocol For Penile Augmentation
    • Extracorporeal Shock Wave Therapy
    • Bocox™ Erectile Dysfunction & Botulinum Toxin Type A
  • Online Tests
    • P-Shot® Treatment - Erectile Dysfunction
    • P-Shot® Treatment - Curved or Bent Penis. Peyronies Disease
    • P Long® Protocol For Penile Augmentation >
      • P-Long Protocol Email Response
    • Extracorporeal Shock Wave Therapy ED
    • Erectile Dysfunction
    • Bocox™ Erectile Dysfunction & Botulinum Toxin Type A
    • Premature Ejaculation
    • Hair Growth Online Test
    • Cosmetic Medicine
    • Sweating Reduction Online Test
    • Privacy Policy
  • Our Services
    • Mens Sexual Health
    • Hair Growth Program
    • Cosmetic Aesthetics
    • Body Aesthetics
    • Sweating Reduction
    • Skincare Products
    • Surgical Procedures
  • About Us
  • Contact Us
  • Blog Dr Mark Morunga
    • Lifestyle Peter Minkoff
  • Frequently Asked Questions
    • Ask A Question
    • P Shot® or Priapus Shot®
    • Peyronie's Disease
    • Erectile Dysfunction
    • Premature Ejaculation
    • Hair Growth Program
    • Wrinkle Treatment
    • Dermal Filler
    • Sweating Reduction

Erectile Dysfunction Online Test 


​This is a validated questionnaire to help identify men who have a problem with Erectile Dysfunction.
Please select the response that best represents your answer for each of the questions below. While your experiences may change from time to time, what we need to know is your general experience with intercourse.

These Online Tests are simple questionnaires that are submitted to our Doctors to see if Essential Men's Clinic has a solution that is right for you. They are obligation free and absolutely confidential. 
    The IIEF-5 (International Index of Erectile Function-5) is an international questionnaire for identifying Erectile Dysfunction. These questions ask about the effects your erection problems have had on your sex life, over the past 4 weeks. Please answer the following questions as honestly and clearly as possible.

    Find out if we can help you. Please give us further information and our Doctor will respond to you within 24 hours.

Submit

Please note that by submitting this form you will be signed up to the Essential Mens Clinic Newsletter. We respect your privacy and you can unsubscribe at anytime.

Our Doctors will to your submission from your given email address.
Your personal details will remain confidential and not disclosed to any third parties.
You have the right to view, change or delete this information on request.
This questionnaire is not comprehensive, and does not replace a full history and physical examination and further information may be necessary on follow-up.
​Due diligence will be exercised for making a thorough assessment.


Picture
Book Your Consultation
Phone 09 523 5999
​Men's Corner
P Shot® or Priapus Shot®
P-Long® Protocol
Extracorporeal Shock Wave Therapy
​Peyronie's Disease
Erectile Dysfunction
Premature Ejaculation


Hair Growth
Pharmaceutical
PRP Hair Growth
Face Aesthetics
Wrinkle
Dermal Filler
Cosmetic Aesthetics
IPL-Intense Pulse Light

Mole Removal
Body Aesthetics
Excessive Sweating 
IPL-Intense Pulse Light
Mole Removal

      Essential Men's Clinic 
    Copyright MML 2019
  • Home
  • Priapus Shot®
    • P-Shot® Research Articles Papers >
      • Is the P-Shot FDA Approved - Essential Mens Clinic
      • P-Shot® Data Information
    • P Long® Protocol For Penile Augmentation
    • Extracorporeal Shock Wave Therapy
    • Bocox™ Erectile Dysfunction & Botulinum Toxin Type A
  • Online Tests
    • P-Shot® Treatment - Erectile Dysfunction
    • P-Shot® Treatment - Curved or Bent Penis. Peyronies Disease
    • P Long® Protocol For Penile Augmentation >
      • P-Long Protocol Email Response
    • Extracorporeal Shock Wave Therapy ED
    • Erectile Dysfunction
    • Bocox™ Erectile Dysfunction & Botulinum Toxin Type A
    • Premature Ejaculation
    • Hair Growth Online Test
    • Cosmetic Medicine
    • Sweating Reduction Online Test
    • Privacy Policy
  • Our Services
    • Mens Sexual Health
    • Hair Growth Program
    • Cosmetic Aesthetics
    • Body Aesthetics
    • Sweating Reduction
    • Skincare Products
    • Surgical Procedures
  • About Us
  • Contact Us
  • Blog Dr Mark Morunga
    • Lifestyle Peter Minkoff
  • Frequently Asked Questions
    • Ask A Question
    • P Shot® or Priapus Shot®
    • Peyronie's Disease
    • Erectile Dysfunction
    • Premature Ejaculation
    • Hair Growth Program
    • Wrinkle Treatment
    • Dermal Filler
    • Sweating Reduction