Are you male and aged between 18-75?
Do you smoke or drink?
Do you have trouble achieving or maintaining your erection?
Do you have high blood pressure (above 160/90), or are you currently on treatment for high blood pressure?
Do you have low blood pressure (below 90/50)?
Have you been advised to avoid strenuous exercise?
Would you have any difficulty walking at a fast pace for 5 minutes?
Do you suffer from depression for which you have not seen a GP?
Do you have any allergy to Viagra (sildenafil), Levitra (vardenafil), Spedra (avanafil) or Cialis (tadalafil) or have you experienced any adverse reaction to any erectile dysfunction medication previously?
Have you ever suffered from any of the problems listed below?
Are you taking any medicines known as nitrates (often taken for chest pain/angina) or nitric oxide donors ('poppers')?
Are you taking any of the following medications?
Do you agree to the following?