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SEXUAL FUNCTIONING AND HISTORY ASSESSMENT Date ___/___/___ Name ___ Age ___ Social Sec. #___ Referring health care provider name / address: ___ Do you have a gynecologist who you have seen in the

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How to fill out sexual functioning and history

01

Start by creating a safe and comfortable environment for the patient to discuss their sexual history.

02

Ask the patient about any past or current sexual relationships and their nature (e.g. monogamous, casual).

03

Inquire about any sexual difficulties the patient may be experiencing, such as erectile dysfunction or loss of libido.

04

Explore the patient's sexual orientation and gender identity, if relevant.

05

Discuss any sexual practices or behaviors that the patient engages in, including any potential risks or concerns.

06

Be nonjudgmental and sensitive to the patient's feelings and experiences throughout the conversation.

Who needs sexual functioning and history?

01

Healthcare professionals such as doctors, therapists, nurses, and sexual health specialists may need to gather sexual functioning and history information from patients.

02

Individuals seeking medical treatment for sexual health issues or concerns may also be asked to provide their sexual functioning and history.

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What is sexual functioning and history?

Sexual functioning and history refers to a comprehensive assessment of an individual's sexual health, including past medical history, sexual behaviors, and any issues or concerns related to sexual function.

Who is required to file sexual functioning and history?

Healthcare providers, specifically those in the fields of sexual health or psychiatry, are usually required to gather and document the sexual functioning and history of their patients.

How to fill out sexual functioning and history?

To fill out sexual functioning and history, healthcare providers typically use standardized questionnaires or forms to gather information about the patient's sexual health, history, and any current concerns or issues.

What is the purpose of sexual functioning and history?

The purpose of sexual functioning and history is to assess an individual's sexual health, identify any potential issues or concerns, and provide appropriate treatment or counseling.

What information must be reported on sexual functioning and history?

Information that may be included in sexual functioning and history could cover past medical history, sexual behaviors, sexual orientation, any sexual dysfunction, and any concerns or issues related to sexual health.

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