R2I Screening
Email *
First Name *
Last Name *
Please enter your email address to receive processed results. We will not spam, sell or share any of your information.
Email Address of your Therapist (for results) *
Please indicate gender *
If you're seeking Christian-focused recovery, please tell us why.
Have you ever been to a 12 step based recovery meeting? *
Would you consider yourself "in recovery" from Alcohol, Substance abuse, or codependency? *
Have you ever considered getting outside professional help for sex issues in general? *
Have you ever questioned whether or not your sex behavior might be putting your recovery at risk? *
Indicate Orientation *
Age *
What is your understanding of your issues with sexual compulsion? *
How many hours per week do you spend engaging in or planning for your sex addiction/acting out? *
What is your estimated annual income in USD? *
As a rough estimate, how much money are you spending on your sex addiction per month (escorts, travel, coverups, site memberships, hush money, etc)? *
Do you believe that their might be another reality; a healthy form of sexuality that feels more fulfilling and doesn't include shame and negative consequences? *
If such a situation were to become available and money was no object, what would it be worth to you? *
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