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Sexual history questionnaire 2025

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The document is a Sexual History Questionnaire designed for individuals with prior sexual offenses. It aims to gather comprehensive information about the individual's sexual history, behaviors, and relationships before their last conviction. The questionnaire emphasizes the importance of truthfulness in responses, as answers will be verified through a polygraph examination. It covers various topics including family background, domestic history, employment, education, substance use, legal status, and detailed inquiries about past sexual contacts and behaviors with minors and adults. The document also outlines the consequences of withholding or falsifying information.

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Click ‘Get Form’ to open the Sexual History Questionnaire in the editor.
Begin by filling in your personal details, including your full name and date of birth. This information is crucial for identification purposes.
Proceed to the Family Background section. Provide details about your parents, including their names and whether they are alive. Be honest about your relationship with them.
In the Residential section, indicate how long you have lived at your current address and whether you live alone. This helps assess your living situation.
Move on to Domestic History. Answer questions regarding marital status and children, ensuring you provide accurate information about past relationships.
Continue through Employment and Education sections, detailing your current job status and educational background as required.
Complete the Alcohol and Drugs section by sharing relevant experiences with substances, which may impact your assessment.
Finally, answer all questions in the Sexual History section thoroughly. If you need more space for any question, utilize additional paper or the back page of the questionnaire.

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2010	4.8 Satisfied (131 Votes)

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What are the 5 Ps of sexual history?

Getting trained on a trauma-informed care approach can help all clinicians provide patient-centered, sensitive care in all interactions. The following questions correspond with CDCs 5Ps approach to taking a sexual history: Partners, Practices, Protection from STIs, Past History of STIs, and Pregnancy Intention.

What are some sexual health questions?

What Questions Might My Health Care Provider Ask Me? Are you sexually active? Do you have sex with men, women, both, or another? What types of sex do you have (oral, vaginal, )? How many people have you ever had sex with? What are you doing to protect yourself from STIs? Have you been tested for STIs, including HIV?

What are some questions about sexual health?

Frequently Asked Questions About Sexual Health Does a man go through menopause? How often should a woman get a pelvic exam and Pap test? What Are the Benefits and Risks of Circumcision? Is vaginal discharge normal? Is hormone replacement therapy for menopause bad for women? Can a woman get pregnant while breastfeeding?

What questions should I ask a patient about sexual health?

Have you or any of your partners used alcohol or drugs when you had sex? Have you ever exchanged sex for drugs or money? Have you ever had a sexually transmitted infection (or disease)? If yes, which STI(s)?

What questions should I ask in sexual history?

If youre asking basic information, then that is relevant. Have you ever been diagnosed with an STD? What STD was it? Are you cured? Do you have children with someone else? Whats the best sex youve ever had and how can we do that better? Have you ever been able to make a fantasy come true, and how did that work out?

psychosexual history questionnaire pdf

Sexual History Questionnaire PDF Sexual History Questionnaire therapy Psychosexual history questionnaire pdf Sexual history questionnaire SHQ Sexual history questions for couples Sexual history polygraph questions Sexual History form STD history and physical

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What are open ended questions about sexual health?

Do you or your partners have other partners? If not currently sexually active, when were you last sexually active? To know what testing you may benefit from, I would like to ask you more about your sexual practices, is that okay? What types of sex do you have?

What should be included in sexual history?

You may need to explore the subjects of abstinence, or not having sex, number of sex partners, use, the patients perception of their own risk and their partners risk, and STI testing. It is important to not assume risk or lack of risk for any patient.

Sexual history questionnaire 2025

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See more sexual history questionnaire versions

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What are the 5 Ps of sexual history?

What are some sexual health questions?

What are some questions about sexual health?

What questions should I ask a patient about sexual health?

What questions should I ask in sexual history?

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What are open ended questions about sexual health?

What should be included in sexual history?

5 ps questionnaire

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