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Sexual history questionnaire 2026

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The document is a Sexual History Questionnaire designed for individuals with prior sexual offense convictions. 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 offenses. The document also outlines the consequences of withholding information and the legal obligations regarding reporting any identifying details about victims.

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Click ‘Get Form’ to open the Sexual History Questionnaire in the editor.
Begin by entering your full name and date of birth at the top of the form. This information is essential 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, as this context is important.
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 details about any past relationships.
Continue through Employment and Education sections, detailing your current job status and educational background. This information contributes to a comprehensive understanding of your history.
Finally, carefully answer all questions in the Sexual History section, providing truthful responses as these will be discussed during your evaluation.

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Versions	Form popularity	Fillable & printable
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?

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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 2026

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