It is for freedom that Christ set you free!

Brother, this is a powerful moment in your journey.  The Bible makes it clear that to be FREE is an identity, a decision and a destination.  You may have never been told that you can walk in complete freedom from sexual confusion, addiction and the lust of the flesh – but that is not what the Lord says!  There is FREEDOM!  Let’s begin the journey together.

Filling out this form may be the first time you have actually been honest about where you are at.  It will also add your email to a weekly email message from BrokenFree, encouraging you to walk in freedom, and connect you to resources to help you discover all that was purchased for you at the cross!

Please answer the following honestly.  The best way is to copy this information into an email and send it – sometimes the form will not submit – but there is a form below in case you want to simply enter it on this page.  If this form will not submit, please copy the questions and send them in an email with your answers.

Your Name (required)

Your Email (required)

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If you have a relationship with the Lord, describe how that came about. If you do not, what spiritual people or influences do you have, read about, or look up to?

Rate yourself at this moment in Selfishness (1=selfless, 10=selfish):

How "big" a problem is porn and sexual sin (1=rare but present, 10=overwhelmingly addicted):

Check ALL that apply

How did you first encounter pornography?

What issues have come about since then? How has it grown or evolved? (Internet, sexual identity issues, masturbation, affairs, prostitution, peeping etc...)

What is driving you to seek help now and do you feel you are ready to do WHATEVER it takes?

How does your struggle impact your relationship with the Lord?