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🛡️ Purity Group Intake

"Therefore, confess your sins to one another and pray for one another, that you may be healed." — James 5:16

Men's Sexual Integrity · Brotherhood · Accountability · Freedom

🔒 All answers kept strictly confidential
Step 1 of 7 ~7 min remaining

🪖 About You

Basic information to help us know who you are. This is the foundation of everything we build together.

🔒 This information is confidential and goes only to the group leader, Adam Johns.
Yes
No
Yes
No

📖 Your Story

This is the section that takes courage. No one is watching — just honesty between you, God, and the man leading this group. Don't edit yourself here.

🔒 What is shared in this group stays in this group. These answers are read only by Adam Johns, the group leader.
Pornography
Emotional affairs
Physical affairs
Compulsive sexual behavior
Sexting / Online
Unsure how to categorize
Other
Never
Once
Multiple times
Currently in a program

📊 Current State

Where are you right now — not six months ago, not at your best, but today? Honest answers here directly shape how we support you.

🔒 These answers are read only by Adam Johns and never shared without your permission.
Yes
No
Unsure
Fully aware
Partially aware
Suspects, not talked
Doesn't know
N/A — Single

✝️ Faith & Support

Freedom from sexual sin is a spiritual battle — not just a habit problem. This section helps us understand your current spiritual footing and support structures.

Active member
Occasional
Not currently
Looking for one
Unsure
Yes — active
Yes — surface-level
No
Unsure
5
1 — Not at all ready 10 — Fully ready

🎯 Goals

Freedom is concrete. Paint the picture for us — what does a different life actually look like for you? The more specific you are, the more we can help.

6
1 — Just looking 10 — All in

🤝 Confidentiality Agreement

Brotherhood only works if the walls are solid. Read this carefully before you agree.

What is shared in this group stays in this group.

The men in this group are trusting each other with their most vulnerable struggles. That trust is sacred. Breaking confidentiality — sharing what someone said with anyone outside the group — is a violation of covenant brotherhood and will result in removal from the group.

This is not just policy. This is how men protect each other.

By checking the box below, you are committing to:

  • Complete confidentiality — what's said here stays here
  • Honesty — the real truth, not the managed version
  • Showing up — consistently, even when it's hard
  • Accountability — receiving hard questions and answering them honestly
  • Respect — for every man's story, journey, and pace

You must check this box to proceed to submission.

✅ Review & Submit

Review your intake below. Adam will reach out within 24 hours to share next steps for the group.

🔒 This information goes directly and only to Adam Johns at USMC Ministries. It is not stored in any public database.

🛡️ You Took the Step

Your intake is submitted. Adam will reach out within 24 hours.

"Therefore, confess your sins to one another and pray for one another, that you may be healed. The prayer of a righteous person has great power as it is working."
— James 5:16
A Word from Coach Moop

It took courage to fill this out. Most men fight this battle alone until it destroys something — their marriage, their ministry, their respect. You didn't wait for that. That matters. We will walk this out together, one week at a time. You are not alone in this fight anymore. Welcome to the brotherhood.

Want to know where you stand? Take the full P.U.R.E. H.E.A.R.T.S. self-assessment.

📊 Take the Assessment →