{"id":2665,"date":"2024-05-07T06:02:20","date_gmt":"2024-05-07T06:02:20","guid":{"rendered":"https:\/\/clinica-urologie.ro\/?page_id=2665"},"modified":"2024-05-07T06:09:31","modified_gmt":"2024-05-07T06:09:31","slug":"formular-de-evaluare-ejaculare-prematura","status":"publish","type":"page","link":"https:\/\/clinica-urologie.ro\/en\/formular-de-evaluare-ejaculare-prematura\/","title":{"rendered":"FORMULAR DE EVALUARE EJACULARE PREMATURA"},"content":{"rendered":"<div data-elementor-type=\"wp-page\" data-elementor-id=\"2665\" class=\"elementor elementor-2665\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-0912d05 elementor-section-height-min-height elementor-section-items-top elementor-section-boxed elementor-section-height-default\" data-id=\"0912d05\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t\t<div class=\"elementor-background-overlay\"><\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-1011d9e\" data-id=\"1011d9e\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-30bdbe5 elementor-widget elementor-widget-heading\" data-id=\"30bdbe5\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">UROLOGY CLINIC<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-71ff9ca elementor-widget elementor-widget-heading\" data-id=\"71ff9ca\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\">RO-BOOST<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-2fdff2d elementor-widget elementor-widget-heading\" data-id=\"2fdff2d\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">dedicata sanatatii sexuale masculine<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a05efdf elementor-align-center elementor-invisible elementor-widget elementor-widget-button\" data-id=\"a05efdf\" data-element_type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeInDown&quot;}\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-size-sm\" role=\"button\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">CONFIDENTIALITY. RELIABILITY. PROFESSIONALISM.<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t<div class=\"elementor-element elementor-element-0750e77 e-flex e-con-boxed e-con e-parent\" data-id=\"0750e77\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-38e1b44 elementor-widget elementor-widget-heading\" data-id=\"38e1b44\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">EVALUATION FORM<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4a9344e elementor-widget elementor-widget-text-editor\" data-id=\"4a9344e\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<ul><li>Completati cu foarte mare atentie formularul de evaluare.<\/li><li>Acest formular nu este facut pentru a diagnostica nicio boala pe care o aveti.<\/li><li>Dupa ce formularul dvs. este evaluat, se decide daca sunteti potrivit pentru program.<\/li><li>Dupa completarea formularului, nu uitati sa apasati butonul\u00a0<strong>TRIMITE<\/strong>.<\/li><li>Dupa ce formularul ajunge la noi, vom raspunde in termen de 1-3 zile lucratoare.<\/li><li>Raspunsul va fi trimis la adresa de e-mail pe care o furnizati. Prin urmare,\u00a0<strong>verificati adresa dvs. de e-mail si asigurati-va ca este corecta.<\/strong><\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-e2b0ebd e-flex e-con-boxed e-con e-parent\" data-id=\"e2b0ebd\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-b0c1762 elementor-widget elementor-widget-wpforms\" data-id=\"b0c1762\" data-element_type=\"widget\" data-widget_type=\"wpforms.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"wpforms-container\" id=\"wpforms-2656\"><form id=\"wpforms-form-2656\" class=\"wpforms-validate wpforms-form wpforms-ajax-form\" data-formid=\"2656\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/en\/wp-json\/wp\/v2\/pages\/2665\" data-token=\"d500a4b1e9a7d77b7955c9aa72e2cb97\" data-token-time=\"1776305858\" data-trp-original-action=\"\/en\/wp-json\/wp\/v2\/pages\/2665\"><noscript class=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/noscript><div class=\"wpforms-field-container\"><div id=\"wpforms-2656-field_1-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"1\"><label class=\"wpforms-field-label\" for=\"wpforms-2656-field_1\">Nume - Prenume <span class=\"wpforms-required-label\">*<\/span><\/label><textarea id=\"wpforms-2656-field_1\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][1]\" required><\/textarea><\/div><div id=\"wpforms-2656-field_2-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"2\"><label class=\"wpforms-field-label\" for=\"wpforms-2656-field_2\">Email  <span class=\"wpforms-required-label\">*<\/span><\/label><textarea id=\"wpforms-2656-field_2\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][2]\" required><\/textarea><\/div><div id=\"wpforms-2656-field_3-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"3\"><label class=\"wpforms-field-label\" for=\"wpforms-2656-field_3\">Telefon <span class=\"wpforms-required-label\">*<\/span><\/label><textarea id=\"wpforms-2656-field_3\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][3]\" required><\/textarea><\/div><div id=\"wpforms-2656-field_4-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"4\"><label class=\"wpforms-field-label\" for=\"wpforms-2656-field_4\">Anul Nasterii <span class=\"wpforms-required-label\">*<\/span><\/label><textarea id=\"wpforms-2656-field_4\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][4]\" required><\/textarea><\/div><div id=\"wpforms-2656-field_5-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"5\"><label class=\"wpforms-field-label\" for=\"wpforms-2656-field_5\">Inaltime \/ Greutate <span class=\"wpforms-required-label\">*<\/span><\/label><textarea id=\"wpforms-2656-field_5\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][5]\" required><\/textarea><div class=\"wpforms-field-description\">cm\/kg<\/div><\/div><div id=\"wpforms-2656-field_6-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"6\"><label class=\"wpforms-field-label\" for=\"wpforms-2656-field_6\">Oras <span class=\"wpforms-required-label\">*<\/span><\/label><textarea id=\"wpforms-2656-field_6\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][6]\" required><\/textarea><\/div><div id=\"wpforms-2656-field_7-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"7\"><label class=\"wpforms-field-label\" for=\"wpforms-2656-field_7\">Care este afectiunea ta sexuala si cand a inceput? Explica pe scurt. <span class=\"wpforms-required-label\">*<\/span><\/label><textarea id=\"wpforms-2656-field_7\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][7]\" required><\/textarea><\/div><div id=\"wpforms-2656-field_9-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"9\"><label class=\"wpforms-field-label\" for=\"wpforms-2656-field_9\">Care au fost diagnosticele facute cu privire la aceasta afectiune, tratamentele pe care le-ai primit si momentul acestora? Sau tu ce metode folosesti? Explica pe scurt. <span class=\"wpforms-required-label\">*<\/span><\/label><textarea id=\"wpforms-2656-field_9\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][9]\" required><\/textarea><\/div><div id=\"wpforms-2656-field_15-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"15\"><label class=\"wpforms-field-label\">Cum sunt obiceiurile tale alimentare? <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-2656-field_15\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_15_1\" name=\"wpforms[fields][15]\" value=\"Sunt atent\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_15_1\">Sunt atent<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_15_2\" name=\"wpforms[fields][15]\" value=\"Nu dau atentie\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_15_2\">Nu dau atentie<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_15_3\" name=\"wpforms[fields][15]\" value=\"Dezorganizat si nesanatos\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_15_3\">Dezorganizat si nesanatos<\/label><\/li><\/ul><\/div><div id=\"wpforms-2656-field_16-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"16\"><label class=\"wpforms-field-label\">Cum este stilul tau de viata?  <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-2656-field_16\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_16_1\" name=\"wpforms[fields][16]\" value=\"Sedentar\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_16_1\">Sedentar<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_16_2\" name=\"wpforms[fields][16]\" value=\"Semi-activ\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_16_2\">Semi-activ<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_16_3\" name=\"wpforms[fields][16]\" value=\"Fac sport\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_16_3\">Fac sport<\/label><\/li><\/ul><\/div><div id=\"wpforms-2656-field_17-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"17\"><label class=\"wpforms-field-label\">Fumezi? <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-2656-field_17\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_17_1\" name=\"wpforms[fields][17]\" value=\"Nu\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_17_1\">Nu<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_17_2\" name=\"wpforms[fields][17]\" value=\"Da, zilnic\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_17_2\">Da, zilnic<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_17_3\" name=\"wpforms[fields][17]\" value=\"Periodic (1-10 tigari pe saptamana)\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_17_3\">Periodic (1-10 tigari pe saptamana)<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_17_4\" name=\"wpforms[fields][17]\" value=\"Periodic (10-20 tigari pe saptamana)\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_17_4\">Periodic (10-20 tigari pe saptamana)<\/label><\/li><\/ul><\/div><div id=\"wpforms-2656-field_18-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"18\"><label class=\"wpforms-field-label\">Consumi alcool?  <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-2656-field_18\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_18_1\" name=\"wpforms[fields][18]\" value=\"Nu\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_18_1\">Nu<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_18_2\" name=\"wpforms[fields][18]\" value=\"1-2 ori pe an\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_18_2\">1-2 ori pe an<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_18_3\" name=\"wpforms[fields][18]\" value=\"o data pe luna\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_18_3\">o data pe luna<\/label><\/li><li class=\"choice-4 depth-1 wpforms-selected\"><input type=\"radio\" id=\"wpforms-2656-field_18_4\" name=\"wpforms[fields][18]\" value=\"o data pe saptamana\" required checked='checked'><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_18_4\">o data pe saptamana<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_18_5\" name=\"wpforms[fields][18]\" value=\"de doua ori pe saptamana\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_18_5\">de doua ori pe saptamana<\/label><\/li><li class=\"choice-6 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_18_6\" name=\"wpforms[fields][18]\" value=\"de 3 ori pe saptamana\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_18_6\">de 3 ori pe saptamana<\/label><\/li><li class=\"choice-7 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_18_7\" name=\"wpforms[fields][18]\" value=\"mai mult de 3 ori pe saptamana\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_18_7\">mai mult de 3 ori pe saptamana<\/label><\/li><\/ul><\/div><div id=\"wpforms-2656-field_19-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"19\"><label class=\"wpforms-field-label\">Starea ta civila? <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-2656-field_19\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_19_1\" name=\"wpforms[fields][19]\" value=\"Singur\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_19_1\">Singur<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_19_2\" name=\"wpforms[fields][19]\" value=\"Casatorit\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_19_2\">Casatorit<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_19_3\" name=\"wpforms[fields][19]\" value=\"Intr-o relatie\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_19_3\">Intr-o relatie<\/label><\/li><\/ul><\/div><div id=\"wpforms-2656-field_20-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"20\"><label class=\"wpforms-field-label\">Ai un partener sexual regulat? <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-2656-field_20\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_20_1\" name=\"wpforms[fields][20]\" value=\"Da\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_20_1\">Da<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_20_2\" name=\"wpforms[fields][20]\" value=\"Nu\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_20_2\">Nu<\/label><\/li><\/ul><\/div><div id=\"wpforms-2656-field_21-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"21\"><label class=\"wpforms-field-label\" for=\"wpforms-2656-field_21\">Care este frecventa ta de masturbare in ultimul an? <span class=\"wpforms-required-label\">*<\/span><\/label><textarea id=\"wpforms-2656-field_21\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][21]\" required><\/textarea><div class=\"wpforms-field-description\">De exemplu: o data pe saptamana, de doua ori pe luna<\/div><\/div><div id=\"wpforms-2656-field_22-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"22\"><label class=\"wpforms-field-label\">Cum te masturbezi? <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-2656-field_22\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_22_1\" name=\"wpforms[fields][22]\" value=\"Nu ma masturbez\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_22_1\">Nu ma masturbez<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_22_2\" name=\"wpforms[fields][22]\" value=\"O fac fara lubrifiere\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_22_2\">O fac fara lubrifiere<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_22_3\" name=\"wpforms[fields][22]\" value=\"Folosesc lubrifiant\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_22_3\">Folosesc lubrifiant<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_22_4\" name=\"wpforms[fields][22]\" value=\"Folosesc sapun - sampon - crema etc.\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_22_4\">Folosesc sapun - sampon - crema etc.<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_22_5\" name=\"wpforms[fields][22]\" value=\"O fac in pat\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_22_5\">O fac in pat<\/label><\/li><li class=\"choice-6 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_22_6\" name=\"wpforms[fields][22]\" value=\"O fac in baie - toaleta\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_22_6\">O fac in baie - toaleta<\/label><\/li><li class=\"choice-7 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_22_7\" name=\"wpforms[fields][22]\" value=\"O fac urmarind filme porno\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_22_7\">O fac urmarind filme porno<\/label><\/li><li class=\"choice-8 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_22_8\" name=\"wpforms[fields][22]\" value=\"O fac prin fantezie\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_22_8\">O fac prin fantezie<\/label><\/li><li class=\"choice-9 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_22_9\" name=\"wpforms[fields][22]\" value=\"O fac repede (dupa relatie)\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_22_9\">O fac repede (dupa relatie)<\/label><\/li><li class=\"choice-10 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_22_10\" name=\"wpforms[fields][22]\" value=\"O fac prin frecare\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_22_10\">O fac prin frecare<\/label><\/li><li class=\"choice-11 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_22_11\" name=\"wpforms[fields][22]\" value=\"O fac prin haine\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_22_11\">O fac prin haine<\/label><\/li><li class=\"choice-12 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_22_12\" name=\"wpforms[fields][22]\" value=\"Folosesc masturbator\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_22_12\">Folosesc masturbator<\/label><\/li><\/ul><\/div><div id=\"wpforms-2656-field_58-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"58\"><label class=\"wpforms-field-label\">Te rugam sa bifezi una sau mai multe dintre urmatoarele situatii <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-2656-field_58\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-2656-field_58_1\" name=\"wpforms[fields][58][]\" value=\"Nu am diabet\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_58_1\">Nu am diabet<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-2656-field_58_2\" name=\"wpforms[fields][58][]\" value=\"Am diabet, sunt sub observatie medicala si nu folosesc medicamente\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_58_2\">Am diabet, sunt sub observatie medicala si nu folosesc medicamente<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"checkbox\" id=\"wpforms-2656-field_58_3\" name=\"wpforms[fields][58][]\" value=\"Am diabet, folosesc pastile\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_58_3\">Am diabet, folosesc pastile<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"checkbox\" id=\"wpforms-2656-field_58_4\" name=\"wpforms[fields][58][]\" value=\"Am diabet, folosesc injectii\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_58_4\">Am diabet, folosesc injectii<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"checkbox\" id=\"wpforms-2656-field_58_5\" name=\"wpforms[fields][58][]\" value=\"Am diabet si nu primesc tratament.\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_58_5\">Am diabet si nu primesc tratament.<\/label><\/li><li class=\"choice-6 depth-1\"><input type=\"checkbox\" id=\"wpforms-2656-field_58_6\" name=\"wpforms[fields][58][]\" value=\"Nu am hipertensiune arteriala\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_58_6\">Nu am hipertensiune arteriala<\/label><\/li><li class=\"choice-7 depth-1\"><input type=\"checkbox\" id=\"wpforms-2656-field_58_7\" name=\"wpforms[fields][58][]\" value=\"Am hipertensiune arteriala, sunt sub observatie medicala si nu folosesc medicamente.\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_58_7\">Am hipertensiune arteriala, sunt sub observatie medicala si nu folosesc medicamente.<\/label><\/li><li class=\"choice-8 depth-1\"><input type=\"checkbox\" id=\"wpforms-2656-field_58_8\" name=\"wpforms[fields][58][]\" value=\"Am hipertensiune arteriala si folosesc medicamente.\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_58_8\">Am hipertensiune arteriala si folosesc medicamente.<\/label><\/li><li class=\"choice-9 depth-1\"><input type=\"checkbox\" id=\"wpforms-2656-field_58_9\" name=\"wpforms[fields][58][]\" value=\"Am hipertensiune arteriala, nu primesc tratament.\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_58_9\">Am hipertensiune arteriala, nu primesc tratament.<\/label><\/li><li class=\"choice-10 depth-1\"><input type=\"checkbox\" id=\"wpforms-2656-field_58_10\" name=\"wpforms[fields][58][]\" value=\"Nu am boli cardiovasculare\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_58_10\">Nu am boli cardiovasculare<\/label><\/li><li class=\"choice-11 depth-1\"><input type=\"checkbox\" id=\"wpforms-2656-field_58_11\" name=\"wpforms[fields][58][]\" value=\"Am boli cardiovasculare, sub observatie\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_58_11\">Am boli cardiovasculare, sub observatie<\/label><\/li><li class=\"choice-12 depth-1\"><input type=\"checkbox\" id=\"wpforms-2656-field_58_12\" name=\"wpforms[fields][58][]\" value=\"Am boli cardiovasculare, folosesc medicamente\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_58_12\">Am boli cardiovasculare, folosesc medicamente<\/label><\/li><li class=\"choice-13 depth-1\"><input type=\"checkbox\" id=\"wpforms-2656-field_58_13\" name=\"wpforms[fields][58][]\" value=\"Am boli cardiovasculare, mi s-a pus un stent\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_58_13\">Am boli cardiovasculare, mi s-a pus un stent<\/label><\/li><li class=\"choice-14 depth-1\"><input type=\"checkbox\" id=\"wpforms-2656-field_58_14\" name=\"wpforms[fields][58][]\" value=\"Am boli cardiovasculare, nu primesc tratament\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_58_14\">Am boli cardiovasculare, nu primesc tratament<\/label><\/li><li class=\"choice-15 depth-1\"><input type=\"checkbox\" id=\"wpforms-2656-field_58_15\" name=\"wpforms[fields][58][]\" value=\"Am boli cardiovasculare, nu primesc tratament\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_58_15\">Am boli cardiovasculare, nu primesc tratament<\/label><\/li><li class=\"choice-16 depth-1\"><input type=\"checkbox\" id=\"wpforms-2656-field_58_16\" name=\"wpforms[fields][58][]\" value=\"Nu am o tulburare de ritm cardiac\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_58_16\">Nu am o tulburare de ritm cardiac<\/label><\/li><li class=\"choice-17 depth-1\"><input type=\"checkbox\" id=\"wpforms-2656-field_58_17\" name=\"wpforms[fields][58][]\" value=\"Am o tulburare de ritm cardiac, folosesc medicamente\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_58_17\">Am o tulburare de ritm cardiac, folosesc medicamente<\/label><\/li><li class=\"choice-18 depth-1\"><input type=\"checkbox\" id=\"wpforms-2656-field_58_18\" name=\"wpforms[fields][58][]\" value=\"Am o tulburare de ritm cardiac, mi s-a instalat un stimulator cardiac\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_58_18\">Am o tulburare de ritm cardiac, mi s-a instalat un stimulator cardiac<\/label><\/li><li class=\"choice-19 depth-1\"><input type=\"checkbox\" id=\"wpforms-2656-field_58_19\" name=\"wpforms[fields][58][]\" value=\"Am o tulburare de ritm cardiac, nu primesc tratament\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_58_19\">Am o tulburare de ritm cardiac, nu primesc tratament<\/label><\/li><li class=\"choice-20 depth-1\"><input type=\"checkbox\" id=\"wpforms-2656-field_58_20\" name=\"wpforms[fields][58][]\" value=\"Nu stiu daca aceste boli exista sau nu\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_58_20\">Nu stiu daca aceste boli exista sau nu<\/label><\/li><\/ul><\/div><div id=\"wpforms-2656-field_24-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"24\"><label class=\"wpforms-field-label\" for=\"wpforms-2656-field_24\">Ai si alte boli in afara de bolile de mai sus? Ce medicamente folosesti, daca exista? <span class=\"wpforms-required-label\">*<\/span><\/label><textarea id=\"wpforms-2656-field_24\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][24]\" required><\/textarea><\/div><div id=\"wpforms-2656-field_60-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"60\"><label class=\"wpforms-field-label\">Ai una sau mai multe dintre urmatoarele probleme? <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-2656-field_60\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-2656-field_60_1\" name=\"wpforms[fields][60][]\" value=\"Nevoie brusca de a urina\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_60_1\">Nevoie brusca de a urina<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-2656-field_60_2\" name=\"wpforms[fields][60][]\" value=\"Mersul la toaleta la intervale mai mici de 2 ore\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_60_2\">Mersul la toaleta la intervale mai mici de 2 ore<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"checkbox\" id=\"wpforms-2656-field_60_3\" name=\"wpforms[fields][60][]\" value=\"Dificultati de a incepe sa urinezi\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_60_3\">Dificultati de a incepe sa urinezi<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"checkbox\" id=\"wpforms-2656-field_60_4\" name=\"wpforms[fields][60][]\" value=\"Scaderea debitului de urina\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_60_4\">Scaderea debitului de urina<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"checkbox\" id=\"wpforms-2656-field_60_5\" name=\"wpforms[fields][60][]\" value=\"Jetul urinar este subtire\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_60_5\">Jetul urinar este subtire<\/label><\/li><li class=\"choice-6 depth-1\"><input type=\"checkbox\" id=\"wpforms-2656-field_60_6\" name=\"wpforms[fields][60][]\" value=\"Urinare intrerupta\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_60_6\">Urinare intrerupta<\/label><\/li><li class=\"choice-7 depth-1\"><input type=\"checkbox\" id=\"wpforms-2656-field_60_7\" name=\"wpforms[fields][60][]\" value=\"Jet urinar imprastiat\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_60_7\">Jet urinar imprastiat<\/label><\/li><li class=\"choice-8 depth-1\"><input type=\"checkbox\" id=\"wpforms-2656-field_60_8\" name=\"wpforms[fields][60][]\" value=\"Picurare la sfarsitul urinarii\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_60_8\">Picurare la sfarsitul urinarii<\/label><\/li><li class=\"choice-9 depth-1\"><input type=\"checkbox\" id=\"wpforms-2656-field_60_9\" name=\"wpforms[fields][60][]\" value=\"Senzatie de mictiune incompleta\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_60_9\">Senzatie de mictiune incompleta<\/label><\/li><li class=\"choice-10 depth-1\"><input type=\"checkbox\" id=\"wpforms-2656-field_60_10\" name=\"wpforms[fields][60][]\" value=\"Durere\/disconfort in zona dintre anus si testicule\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_60_10\">Durere\/disconfort in zona dintre anus si testicule<\/label><\/li><li class=\"choice-11 depth-1\"><input type=\"checkbox\" id=\"wpforms-2656-field_60_11\" name=\"wpforms[fields][60][]\" value=\"Arsuri si dureri in capul penisului\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_60_11\">Arsuri si dureri in capul penisului<\/label><\/li><li class=\"choice-12 depth-1\"><input type=\"checkbox\" id=\"wpforms-2656-field_60_12\" name=\"wpforms[fields][60][]\" value=\"Secretie din varful penisului (cu exceptia actului sexual)\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_60_12\">Secretie din varful penisului (cu exceptia actului sexual)<\/label><\/li><li class=\"choice-13 depth-1\"><input type=\"checkbox\" id=\"wpforms-2656-field_60_13\" name=\"wpforms[fields][60][]\" value=\"Nu ma incadrez\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_60_13\">Nu ma incadrez<\/label><\/li><\/ul><\/div><div id=\"wpforms-2656-field_26-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"26\"><label class=\"wpforms-field-label\" for=\"wpforms-2656-field_26\"> Ai primit vreodata tratament pentru problemele de mai sus? Explica pe scurt. <span class=\"wpforms-required-label\">*<\/span><\/label><textarea id=\"wpforms-2656-field_26\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][26]\" required><\/textarea><\/div><div id=\"wpforms-2656-field_27-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"27\"><label class=\"wpforms-field-label\" for=\"wpforms-2656-field_27\">Te-ai operat? <span class=\"wpforms-required-label\">*<\/span><\/label><textarea id=\"wpforms-2656-field_27\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][27]\" required><\/textarea><div class=\"wpforms-field-description\">Scrie numele, anul si motivul operatiei<\/div><\/div><div id=\"wpforms-2656-field_28-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"28\"><label class=\"wpforms-field-label\" for=\"wpforms-2656-field_28\">Care este afectiunea ta sexuala si cand a inceput? Explica pe scurt. <span class=\"wpforms-required-label\">*<\/span><\/label><textarea id=\"wpforms-2656-field_28\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][28]\" required><\/textarea><\/div><div id=\"wpforms-2656-field_29-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"29\"><label class=\"wpforms-field-label\">Care este scorul fermitatii erectiei in preludiu? <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-2656-field_29\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_29_1\" name=\"wpforms[fields][29]\" value=\"Nu am fost niciodata intr-o relatie\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_29_1\">Nu am fost niciodata intr-o relatie<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_29_2\" name=\"wpforms[fields][29]\" value=\"0, fara duritate\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_29_2\">0, fara duritate<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_29_3\" name=\"wpforms[fields][29]\" value=\"1-4, fermitate slaba (nu poate patrunde in vagin)\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_29_3\">1-4, fermitate slaba (nu poate patrunde in vagin)<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_29_4\" name=\"wpforms[fields][29]\" value=\"5, abia intra in vagin\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_29_4\">5, abia intra in vagin<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_29_5\" name=\"wpforms[fields][29]\" value=\"6-7, fermitate buna (permite intrarea in vagin)\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_29_5\">6-7, fermitate buna (permite intrarea in vagin)<\/label><\/li><li class=\"choice-6 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_29_6\" name=\"wpforms[fields][29]\" value=\"8-9 duritate buna (permite patrunderea in vagin)\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_29_6\">8-9 duritate buna (permite patrunderea in vagin)<\/label><\/li><li class=\"choice-7 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_29_7\" name=\"wpforms[fields][29]\" value=\"10, duritate completa\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_29_7\">10, duritate completa<\/label><\/li><\/ul><\/div><div id=\"wpforms-2656-field_30-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"30\"><label class=\"wpforms-field-label\">Care este scorul fermitatii in timpul actului sexual? <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-2656-field_30\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_30_1\" name=\"wpforms[fields][30]\" value=\"Nu am fost niciodata intr-o relatie\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_30_1\">Nu am fost niciodata intr-o relatie<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_30_2\" name=\"wpforms[fields][30]\" value=\"0, fara duritate\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_30_2\">0, fara duritate<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_30_3\" name=\"wpforms[fields][30]\" value=\"Erectie initiala dura, pierderea completa a erectiei inainte de penetrare\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_30_3\">Erectie initiala dura, pierderea completa a erectiei inainte de penetrare<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_30_4\" name=\"wpforms[fields][30]\" value=\"Erectie initiala dura, pierderea completa a erectiei in interiorul vaginului.\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_30_4\">Erectie initiala dura, pierderea completa a erectiei in interiorul vaginului.<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_30_5\" name=\"wpforms[fields][30]\" value=\"intravaginal 1-4, fermitate slaba (nu poate patrunde in vagin)\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_30_5\">intravaginal 1-4, fermitate slaba (nu poate patrunde in vagin)<\/label><\/li><li class=\"choice-6 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_30_6\" name=\"wpforms[fields][30]\" value=\"5, abia intra in vagin\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_30_6\">5, abia intra in vagin<\/label><\/li><li class=\"choice-7 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_30_7\" name=\"wpforms[fields][30]\" value=\"6-7, fermitate buna (permite intrarea in vagin)\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_30_7\">6-7, fermitate buna (permite intrarea in vagin)<\/label><\/li><li class=\"choice-8 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_30_8\" name=\"wpforms[fields][30]\" value=\"8-9, duritate buna (permite patrunderea in vagin)\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_30_8\">8-9, duritate buna (permite patrunderea in vagin)<\/label><\/li><li class=\"choice-9 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_30_9\" name=\"wpforms[fields][30]\" value=\"10, duritate completa\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_30_9\">10, duritate completa<\/label><\/li><\/ul><\/div><div id=\"wpforms-2656-field_31-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"31\"><label class=\"wpforms-field-label\">Care este scorul fermitatii erectiei in timpul preludiilor folosind medicamente, injectii sau alte suplimente? <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-2656-field_31\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_31_1\" name=\"wpforms[fields][31]\" value=\"Nu am fost niciodata intr-o relatie\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_31_1\">Nu am fost niciodata intr-o relatie<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_31_2\" name=\"wpforms[fields][31]\" value=\"0, fara duritate\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_31_2\">0, fara duritate<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_31_3\" name=\"wpforms[fields][31]\" value=\"Erectie initiala dura, pierderea completa a erectiei inainte de penetrare\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_31_3\">Erectie initiala dura, pierderea completa a erectiei inainte de penetrare<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_31_4\" name=\"wpforms[fields][31]\" value=\"Erectie initiala dura, pierderea completa a erectiei in interiorul vaginului.\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_31_4\">Erectie initiala dura, pierderea completa a erectiei in interiorul vaginului.<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_31_5\" name=\"wpforms[fields][31]\" value=\"intravaginal 1-4, fermitate slaba (nu poate patrunde in vagin)\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_31_5\">intravaginal 1-4, fermitate slaba (nu poate patrunde in vagin)<\/label><\/li><li class=\"choice-6 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_31_6\" name=\"wpforms[fields][31]\" value=\"5, abia intra in vagin\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_31_6\">5, abia intra in vagin<\/label><\/li><li class=\"choice-7 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_31_7\" name=\"wpforms[fields][31]\" value=\"6-7, fermitate buna (permite intrarea in vagin)\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_31_7\">6-7, fermitate buna (permite intrarea in vagin)<\/label><\/li><li class=\"choice-8 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_31_8\" name=\"wpforms[fields][31]\" value=\"8-9, duritate buna (permite patrunderea in vagin)\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_31_8\">8-9, duritate buna (permite patrunderea in vagin)<\/label><\/li><li class=\"choice-9 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_31_9\" name=\"wpforms[fields][31]\" value=\"10, duritate completa\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_31_9\">10, duritate completa<\/label><\/li><\/ul><\/div><div id=\"wpforms-2656-field_32-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"32\"><label class=\"wpforms-field-label\">Care este scorul fermitatii erectiei in actul sexual prin luarea de medicamente, injectii sau alte suplimente? <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-2656-field_32\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_32_1\" name=\"wpforms[fields][32]\" value=\"Nu am fost niciodata intr-o relatie\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_32_1\">Nu am fost niciodata intr-o relatie<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_32_2\" name=\"wpforms[fields][32]\" value=\"0, fara duritate\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_32_2\">0, fara duritate<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_32_3\" name=\"wpforms[fields][32]\" value=\"Erectie initiala dura, pierderea completa a erectiei inainte de penetrare\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_32_3\">Erectie initiala dura, pierderea completa a erectiei inainte de penetrare<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_32_4\" name=\"wpforms[fields][32]\" value=\"Erectie initiala dura, pierderea completa a erectiei in interiorul vaginului.\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_32_4\">Erectie initiala dura, pierderea completa a erectiei in interiorul vaginului.<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_32_5\" name=\"wpforms[fields][32]\" value=\"intravaginal 1-4, fermitate slaba (nu poate patrunde in vagin)\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_32_5\">intravaginal 1-4, fermitate slaba (nu poate patrunde in vagin)<\/label><\/li><li class=\"choice-6 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_32_6\" name=\"wpforms[fields][32]\" value=\"5, abia intra in vagin\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_32_6\">5, abia intra in vagin<\/label><\/li><li class=\"choice-7 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_32_7\" name=\"wpforms[fields][32]\" value=\"6-7, fermitate buna (permite intrarea in vagin)\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_32_7\">6-7, fermitate buna (permite intrarea in vagin)<\/label><\/li><li class=\"choice-8 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_32_8\" name=\"wpforms[fields][32]\" value=\"8-9, duritate buna (permite patrunderea in vagin)\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_32_8\">8-9, duritate buna (permite patrunderea in vagin)<\/label><\/li><li class=\"choice-9 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_32_9\" name=\"wpforms[fields][32]\" value=\"10, duritate completa\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_32_9\">10, duritate completa<\/label><\/li><\/ul><\/div><div id=\"wpforms-2656-field_33-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"33\"><label class=\"wpforms-field-label\">Care este scorul fermitatii erectiei la masturbare? <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-2656-field_33\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_33_1\" name=\"wpforms[fields][33]\" value=\"Nu am fost niciodata intr-o relatie\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_33_1\">Nu am fost niciodata intr-o relatie<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_33_2\" name=\"wpforms[fields][33]\" value=\"0, fara duritate\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_33_2\">0, fara duritate<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_33_3\" name=\"wpforms[fields][33]\" value=\"Erectie initiala dura, pierderea completa a erectiei inainte de penetrare\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_33_3\">Erectie initiala dura, pierderea completa a erectiei inainte de penetrare<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_33_4\" name=\"wpforms[fields][33]\" value=\"Erectie initiala dura, pierderea completa a erectiei in interiorul vaginului.\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_33_4\">Erectie initiala dura, pierderea completa a erectiei in interiorul vaginului.<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_33_5\" name=\"wpforms[fields][33]\" value=\"intravaginal 1-4, fermitate slaba (nu poate patrunde in vagin)\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_33_5\">intravaginal 1-4, fermitate slaba (nu poate patrunde in vagin)<\/label><\/li><li class=\"choice-6 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_33_6\" name=\"wpforms[fields][33]\" value=\"5, abia intra in vagin\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_33_6\">5, abia intra in vagin<\/label><\/li><li class=\"choice-7 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_33_7\" name=\"wpforms[fields][33]\" value=\"6-7, fermitate buna (permite intrarea in vagin)\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_33_7\">6-7, fermitate buna (permite intrarea in vagin)<\/label><\/li><li class=\"choice-8 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_33_8\" name=\"wpforms[fields][33]\" value=\"8-9, duritate buna (permite patrunderea in vagin)\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_33_8\">8-9, duritate buna (permite patrunderea in vagin)<\/label><\/li><li class=\"choice-9 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_33_9\" name=\"wpforms[fields][33]\" value=\"10, duritate completa\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_33_9\">10, duritate completa<\/label><\/li><\/ul><\/div><div id=\"wpforms-2656-field_34-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"34\"><label class=\"wpforms-field-label\" for=\"wpforms-2656-field_34\">Care este numele medicamentului pe care il utilizati pentru erectie, cum se utilizeaza si cate miligrame are?<\/label><textarea id=\"wpforms-2656-field_34\" class=\"wpforms-field-medium\" name=\"wpforms[fields][34]\" ><\/textarea><\/div><div id=\"wpforms-2656-field_35-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"35\"><label class=\"wpforms-field-label\">Exista o diferenta in fermitatea erectiei tale la contactul cu parteneri diferiti? <\/label><ul id=\"wpforms-2656-field_35\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_35_1\" name=\"wpforms[fields][35]\" value=\"Nu am nicio relatie\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_35_1\">Nu am nicio relatie<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_35_2\" name=\"wpforms[fields][35]\" value=\"Am un singur partener\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_35_2\">Am un singur partener<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_35_3\" name=\"wpforms[fields][35]\" value=\"Da, exista o diferenta\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_35_3\">Da, exista o diferenta<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_35_4\" name=\"wpforms[fields][35]\" value=\"La fel in toate relatiile\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_35_4\">La fel in toate relatiile<\/label><\/li><\/ul><\/div><div id=\"wpforms-2656-field_36-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"36\"><label class=\"wpforms-field-label\" for=\"wpforms-2656-field_36\">Exista curbura a penisului in timpul erectiei? Daca da, de cat timp exista?<\/label><textarea id=\"wpforms-2656-field_36\" class=\"wpforms-field-medium\" name=\"wpforms[fields][36]\" ><\/textarea><\/div><div id=\"wpforms-2656-field_37-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"37\"><label class=\"wpforms-field-label\" for=\"wpforms-2656-field_37\">Exista dureri in penis in timpul erectiei? Daca da, de cat timp exista?<\/label><textarea id=\"wpforms-2656-field_37\" class=\"wpforms-field-medium\" name=\"wpforms[fields][37]\" ><\/textarea><\/div><div id=\"wpforms-2656-field_38-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"38\"><label class=\"wpforms-field-label\" for=\"wpforms-2656-field_38\">Simti un nodul dur in penis in timpul erectiei? Daca da, de cat timp exista?<\/label><textarea id=\"wpforms-2656-field_38\" class=\"wpforms-field-medium\" name=\"wpforms[fields][38]\" ><\/textarea><\/div><div id=\"wpforms-2656-field_39-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"39\"><label class=\"wpforms-field-label\" for=\"wpforms-2656-field_39\">Scrieti pe scurt ce doriti sa adaugati despre erectie.<\/label><textarea id=\"wpforms-2656-field_39\" class=\"wpforms-field-medium\" name=\"wpforms[fields][39]\" ><\/textarea><\/div><div id=\"wpforms-2656-field_40-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"40\"><label class=\"wpforms-field-label\">De cat timp ai probleme cu ejacularea? <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-2656-field_40\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_40_1\" name=\"wpforms[fields][40]\" value=\"Nu am probleme de ejaculare\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_40_1\">Nu am probleme de ejaculare<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_40_2\" name=\"wpforms[fields][40]\" value=\"Nu stiu daca am probleme cu ejacularea\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_40_2\">Nu stiu daca am probleme cu ejacularea<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_40_3\" name=\"wpforms[fields][40]\" value=\"Am de cand imi amintesc.\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_40_3\">Am de cand imi amintesc.<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_40_4\" name=\"wpforms[fields][40]\" value=\"A inceput in ultimul an\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_40_4\">A inceput in ultimul an<\/label><\/li><\/ul><\/div><div id=\"wpforms-2656-field_41-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"41\"><label class=\"wpforms-field-label\">Care este scorul tau de ejaculare in timpul actului sexual? <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-2656-field_41\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_41_1\" name=\"wpforms[fields][41]\" value=\"0, Ejacularea dupa actul sexual (intrarea si iesirea din vagin de peste 120 de ori)\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_41_1\">0, Ejacularea dupa actul sexual (intrarea si iesirea din vagin de peste 120 de ori)<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_41_2\" name=\"wpforms[fields][41]\" value=\"1, Ejacularea dupa actul sexual (intrarea si iesirea din vagin de 30-120 de ori)\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_41_2\">1, Ejacularea dupa actul sexual (intrarea si iesirea din vagin de 30-120 de ori)<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_41_3\" name=\"wpforms[fields][41]\" value=\"2, Ejacularea dupa actul sexual (intrarea si iesirea din vagin de 10-30 de ori)\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_41_3\">2, Ejacularea dupa actul sexual (intrarea si iesirea din vagin de 10-30 de ori)<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_41_4\" name=\"wpforms[fields][41]\" value=\"3, Ejaculare imediat ce incepeti actul sexual (intrarea si iesirea din vagin de 1-10 ori)\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_41_4\">3, Ejaculare imediat ce incepeti actul sexual (intrarea si iesirea din vagin de 1-10 ori)<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_41_5\" name=\"wpforms[fields][41]\" value=\"4, Ejaculare in timpul preludiului inainte de actul sexual\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_41_5\">4, Ejaculare in timpul preludiului inainte de actul sexual<\/label><\/li><li class=\"choice-6 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_41_6\" name=\"wpforms[fields][41]\" value=\"5, Nu pot ejacula in timpul actului sexual\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_41_6\">5, Nu pot ejacula in timpul actului sexual<\/label><\/li><li class=\"choice-7 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_41_7\" name=\"wpforms[fields][41]\" value=\"6, Nu-mi amintesc perioada fara medicamente sau suplimente\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_41_7\">6, Nu-mi amintesc perioada fara medicamente sau suplimente<\/label><\/li><li class=\"choice-8 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_41_8\" name=\"wpforms[fields][41]\" value=\"7, Nu am avut niciodata o relatie\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_41_8\">7, Nu am avut niciodata o relatie<\/label><\/li><\/ul><\/div><div id=\"wpforms-2656-field_42-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"42\"><label class=\"wpforms-field-label\">Care este scorul tau de ejaculare in timpul actului sexual prin luarea de medicamente sau suplimente? <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-2656-field_42\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_42_1\" name=\"wpforms[fields][42]\" value=\"Nu am nicio relatie\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_42_1\">Nu am nicio relatie<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_42_2\" name=\"wpforms[fields][42]\" value=\"Nu am folosit niciodata\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_42_2\">Nu am folosit niciodata<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_42_3\" name=\"wpforms[fields][42]\" value=\"1, Nicio schimbare\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_42_3\">1, Nicio schimbare<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_42_4\" name=\"wpforms[fields][42]\" value=\"2, Vaga schimbare\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_42_4\">2, Vaga schimbare<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_42_5\" name=\"wpforms[fields][42]\" value=\"3, Dureaza suficient de mult pentru a fi satisfacut\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_42_5\">3, Dureaza suficient de mult pentru a fi satisfacut<\/label><\/li><li class=\"choice-6 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_42_6\" name=\"wpforms[fields][42]\" value=\"4, Nu pot ejacula in timpul actului sexual\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_42_6\">4, Nu pot ejacula in timpul actului sexual<\/label><\/li><\/ul><\/div><div id=\"wpforms-2656-field_43-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"43\"><label class=\"wpforms-field-label\">Ati primit vreunul dintre urmatoarele tratamente pentru a controla ejacularea? <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-2656-field_43\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_43_1\" name=\"wpforms[fields][43]\" value=\"Nu am primit niciodata tratament\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_43_1\">Nu am primit niciodata tratament<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_43_2\" name=\"wpforms[fields][43]\" value=\"Am folosit un prezervativ\/prezervativ de intarziere\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_43_2\">Am folosit un prezervativ\/prezervativ de intarziere<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_43_3\" name=\"wpforms[fields][43]\" value=\"Am folosit spray anestezic\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_43_3\">Am folosit spray anestezic<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_43_4\" name=\"wpforms[fields][43]\" value=\"Am folosit crema\/servetele anestezice\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_43_4\">Am folosit crema\/servetele anestezice<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_43_5\" name=\"wpforms[fields][43]\" value=\"Am luat medicamente in fiecare zi mult timp\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_43_5\">Am luat medicamente in fiecare zi mult timp<\/label><\/li><li class=\"choice-6 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_43_6\" name=\"wpforms[fields][43]\" value=\"Am folosit medicamente inainte de actul sexual\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_43_6\">Am folosit medicamente inainte de actul sexual<\/label><\/li><li class=\"choice-7 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_43_7\" name=\"wpforms[fields][43]\" value=\"Am primit terapie sexuala\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_43_7\">Am primit terapie sexuala<\/label><\/li><li class=\"choice-8 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_43_8\" name=\"wpforms[fields][43]\" value=\"Am primit terapie comportamentala\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_43_8\">Am primit terapie comportamentala<\/label><\/li><li class=\"choice-9 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_43_9\" name=\"wpforms[fields][43]\" value=\"Am folosit dispozitive tehnologice (vibratoare).\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_43_9\">Am folosit dispozitive tehnologice (vibratoare).<\/label><\/li><li class=\"choice-10 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_43_10\" name=\"wpforms[fields][43]\" value=\"Am facut exercitii pe cont propriu\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_43_10\">Am facut exercitii pe cont propriu<\/label><\/li><\/ul><\/div><div id=\"wpforms-2656-field_45-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"45\"><label class=\"wpforms-field-label\" for=\"wpforms-2656-field_45\">Daca folosesti medicamente, mentioneaza denumirea si doza.<\/label><textarea id=\"wpforms-2656-field_45\" class=\"wpforms-field-medium\" name=\"wpforms[fields][45]\" ><\/textarea><\/div><div id=\"wpforms-2656-field_46-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"46\"><label class=\"wpforms-field-label\" for=\"wpforms-2656-field_46\"> Daca te incadrezi la cele doua rubrici anterioare, te rugam sa explici efectul metodelor pe care le utilizati asupra ejacularii.<\/label><textarea id=\"wpforms-2656-field_46\" class=\"wpforms-field-medium\" name=\"wpforms[fields][46]\" ><\/textarea><\/div><div id=\"wpforms-2656-field_47-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"47\"><label class=\"wpforms-field-label\">Exista o diferenta in timpul de ejaculare intre partenerii tai sexuali? <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-2656-field_47\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_47_1\" name=\"wpforms[fields][47]\" value=\"Nu am nicio relatie\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_47_1\">Nu am nicio relatie<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_47_2\" name=\"wpforms[fields][47]\" value=\"Am un singur partener\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_47_2\">Am un singur partener<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_47_3\" name=\"wpforms[fields][47]\" value=\"Da, exista o diferenta\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_47_3\">Da, exista o diferenta<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_47_4\" name=\"wpforms[fields][47]\" value=\"La fel in toate relatiile\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_47_4\">La fel in toate relatiile<\/label><\/li><\/ul><\/div><div id=\"wpforms-2656-field_48-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"48\"><label class=\"wpforms-field-label\">Este penisul tau sensibil in timpul actului sexual sau al masturbarii? <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-2656-field_48\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_48_1\" name=\"wpforms[fields][48]\" value=\"Da\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_48_1\">Da<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_48_2\" name=\"wpforms[fields][48]\" value=\"Nu\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_48_2\">Nu<\/label><\/li><\/ul><\/div><div id=\"wpforms-2656-field_49-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"49\"><label class=\"wpforms-field-label\" for=\"wpforms-2656-field_49\">Daca nu poti ejacula in timpul actului sexual, ce faci pentru a ejacula dupa aceea?<\/label><textarea id=\"wpforms-2656-field_49\" class=\"wpforms-field-medium\" name=\"wpforms[fields][49]\" ><\/textarea><\/div><div id=\"wpforms-2656-field_50-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"50\"><label class=\"wpforms-field-label\">Care este scorul tau de dorinta sexuala? <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-2656-field_50\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_50_1\" name=\"wpforms[fields][50]\" value=\"0, Nu am nicio dorinta, nici nu-mi vine in minte.\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_50_1\">0, Nu am nicio dorinta, nici nu-mi vine in minte.<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_50_2\" name=\"wpforms[fields][50]\" value=\"1, Dorinta mea este foarte mica\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_50_2\">1, Dorinta mea este foarte mica<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_50_3\" name=\"wpforms[fields][50]\" value=\"2, Dorinta mea este mai mica decat inainte\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_50_3\">2, Dorinta mea este mai mica decat inainte<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_50_4\" name=\"wpforms[fields][50]\" value=\"3, Dorinta mea este normala\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_50_4\">3, Dorinta mea este normala<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_50_5\" name=\"wpforms[fields][50]\" value=\"4, Dorinta mea este exagerata\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_50_5\">4, Dorinta mea este exagerata<\/label><\/li><\/ul><\/div><div id=\"wpforms-2656-field_51-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"51\"><label class=\"wpforms-field-label\">Partenerul tau are probleme in relatie? (Convulsii \/ arsuri etc.) <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-2656-field_51\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_51_1\" name=\"wpforms[fields][51]\" value=\"Da\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_51_1\">Da<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-2656-field_51_2\" name=\"wpforms[fields][51]\" value=\"Nu\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_51_2\">Nu<\/label><\/li><\/ul><\/div><div id=\"wpforms-2656-field_52-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"52\"><label class=\"wpforms-field-label\" for=\"wpforms-2656-field_52\">Care este dimensiunea penisului tau cand esti in erectie? <span class=\"wpforms-required-label\">*<\/span><\/label><textarea id=\"wpforms-2656-field_52\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][52]\" required><\/textarea><div class=\"wpforms-field-description\">**cm<\/div><\/div><div id=\"wpforms-2656-field_56-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"56\"><label class=\"wpforms-field-label\">ACORD DE UTILIZARE A DATELOR PERSONALE <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-2656-field_56\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-2656-field_56_1\" name=\"wpforms[fields][56][]\" value=\"DE ACORD\" required><label class=\"wpforms-field-label-inline\" for=\"wpforms-2656-field_56_1\">DE ACORD<\/label><\/li><\/ul><div class=\"wpforms-field-description\">Datele personale furnizate sunt utilizate in scopul de a raspunde solicitarilor dvs. Mai multe Informatii despre protectia datelor cu caracter personal regasiti pe: https:\/\/europa.eu\/youreurope\/business\/dealing-with-customers\/data-protection\/data-protection-gdpr\/index_ro.htm<\/div><\/div><\/div><!-- .wpforms-field-container --><div class=\"wpforms-submit-container\" ><input type=\"hidden\" name=\"wpforms[id]\" value=\"2656\"><input type=\"hidden\" name=\"page_title\" value=\"\"><input type=\"hidden\" name=\"page_url\" value=\"https:\/\/clinica-urologie.ro\/en\/wp-json\/wp\/v2\/pages\/2665\"><input type=\"hidden\" name=\"url_referer\" value=\"\"><button type=\"submit\" name=\"wpforms[submit]\" id=\"wpforms-submit-2656\" class=\"wpforms-submit\" data-alt-text=\"Se trimite...\" data-submit-text=\"TRIMITE\" aria-live=\"assertive\" value=\"wpforms-submit\">TRIMITE<\/button><img decoding=\"async\" src=\"https:\/\/clinica-urologie.ro\/wp-content\/plugins\/wpforms-lite\/assets\/images\/submit-spin.svg\" class=\"wpforms-submit-spinner\" style=\"display: none;\" width=\"26\" height=\"26\" alt=\"Loading\"><\/div><input type=\"hidden\" name=\"trp-form-language\" value=\"en\"\/><\/form><\/div>  <!-- .wpforms-container -->\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>CLINICA DE UROLOGIE RO-BOOST dedicata sanatatii sexuale masculine CONFIDENTIALITATE. SERIOZITATE. PROFESIONALISM. FORMULAR DE EVALUARE Completati cu foarte mare atentie formularul de evaluare. Acest formular nu este facut pentru a diagnostica nicio boala pe care o aveti. Dupa ce formularul dvs. este evaluat, se decide daca sunteti potrivit pentru program. Dupa completarea formularului, nu uitati sa [&hellip;]<\/p>","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"site-sidebar-layout":"no-sidebar","site-content-layout":"page-builder","ast-site-content-layout":"full-width-container","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"disabled","ast-breadcrumbs-content":"","ast-featured-img":"disabled","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"class_list":["post-2665","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/clinica-urologie.ro\/en\/wp-json\/wp\/v2\/pages\/2665","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/clinica-urologie.ro\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/clinica-urologie.ro\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/clinica-urologie.ro\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/clinica-urologie.ro\/en\/wp-json\/wp\/v2\/comments?post=2665"}],"version-history":[{"count":10,"href":"https:\/\/clinica-urologie.ro\/en\/wp-json\/wp\/v2\/pages\/2665\/revisions"}],"predecessor-version":[{"id":2684,"href":"https:\/\/clinica-urologie.ro\/en\/wp-json\/wp\/v2\/pages\/2665\/revisions\/2684"}],"wp:attachment":[{"href":"https:\/\/clinica-urologie.ro\/en\/wp-json\/wp\/v2\/media?parent=2665"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}