Join the Group

Intake Process

The intake process exists to help the facilitator understand where you are and how to serve you well. There are no wrong answers.

Before You Apply

What to Expect

Completing this intake is step one. After submission, the facilitator will reach out within a few days to schedule a brief call. That call is not an interview or a test — it is a conversation to make sure the group is the right fit for where you are right now.

All information submitted here is strictly confidential. It is read only by the facilitator and is never shared. Read the full confidentiality commitment.

About You

Full Name *

Email Address *

Phone Number

Age Range

Your Situation

Marital Status

Single Married Divorced / Separated Prefer not to say

How would you describe your church involvement?

Active member of a local church Attending but not fully plugged in Sporadic — looking for community Not currently attending anywhere

Briefly describe your situation and what you are hoping to find in this group. *

There are no wrong answers. The more honest you are, the better we can serve you.

How long have you been dealing with this?

Have you sought help for this before? (check all that apply)

Individual counseling or therapy A small group or accountability group Accountability software (Covenant Eyes, etc.) Self-study (books, courses) No — this is my first step

Commitment

Are you able to commit to all 12 weeks? *

Yes — I intend to complete the full 12 weeks Mostly — I may have 1–2 conflicts I'm not sure yet — I'd like to discuss

Do you agree to the confidentiality commitment? *

Yes — I will hold all group content in strict confidence

Read the full confidentiality commitment before agreeing.

Anything else you want the facilitator to know?

This information is confidential and read only by the facilitator. Confidentiality policy.

Prefer to reach out directly? Contact the facilitator.