Sexual Communication Questionnaire
A private questionnaire to understand communication comfort, boundaries, and support needs around intimate conversations. Use the exact title consistently throughout the form.
Respondent Details
Respondent Name
*
First Name
Middle Name
Last Name
Preferred Contact Method
*
Email
Phone
Text Message
Other
Contact Details
*
Communication Context
Relationship or communication context
*
Please Select
Partner
Dating
Established relationship
Casual connection
Ex-partner
Not specified
Other
How long have you been communicating?
*
General situation or setting
Comfort and Boundaries
How comfortable are you discussing intimate topics?
*
Not comfortable
1
2
3
4
5
6
7
8
9
Very comfortable
10
1 is Not comfortable, 10 is Very comfortable
Are there any topics or communication boundaries you want to avoid?
What kind of support or guidance would you like from this questionnaire?
Communication tips
Boundary-setting guidance
Conversation starters
Relationship advice
Confidence-building strategies
Other
Follow-up
Would you like follow-up or coaching suggestions?
*
Yes
No
Preferred follow-up format
Please Select
Written summary
Private call
Text message
Email
Other
Additional notes
Submit Sexual Communication Questionnaire
Should be Empty: