STEP 2 - CAN YOU TELL US A LITTLE MORE?

WE REALLY WANT TO TAILOR OUR SUPPORT FOR YOUR INDIVIDUAL NEEDS. YOU CAN HELP US BY TELLING US MORE ABOUT THE FOLLOWING:

    1

    What is the sex/porn addiction you are struggling with?

    PORNPROMISCUITYMASTURBATIONSEX WITH PARTNER

    2

    How often do you engage in that?


    Times or less

    PER DAY

    3

    How much do you spend in a month?

    £

    £

    or less,

    PER WEEK

    4

    How does it negatively impact on your life?

    5

    What's the impact on family and friends?

    6

    Have you been diagnosed with depression or any other mental health condition?

    7

    How have you tried to stop before?

    If Yes, please give details of anything you've tried before

    8

    How much support do you think you need to stop?

    9

    Why have you decided to face your sex/porn addiction now?

    10

    What does your life look like free from the addiction?

    11

    Do you have any underlying health conditions or diagnosed health conditions? (Please give details here)

    12

    About You


    13

    Your Contact Details



     

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