Reducing the Pain Associated with Pornography Use
This is an anonymous survey used for data purposes only. Help us increase our awareness!
Sign in to Google to save your progress. Learn more
What is your gender?
Clear selection
What is your Age?
Clear selection
Have you ever been exposed to Pornography?
Clear selection
If you answered yes at what age were you exposed?
Clear selection
Viewing pornography is normal and hurts no one:
Clear selection
I view porography:
Clear selection
If you do view Pornography does anyone know about it?
Clear selection
Are you aware of any support groups regarding pornography addiction?
Clear selection
Do you attend any support groups for pornography addiction?
Clear selection
Has your pornography addiction ever interfered with your: (select all that apply)
Do you wish there was more support or awareness around pornography?
Clear selection
Do you know someone who struggles with a Pornography Addiction?
Clear selection
I would know how to help someone who is struggling with pornography:
Clear selection
I would feel comfortable with a loved one asking me for help with their pornagraphy addiction:
Clear selection
What is your Zip Code?
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms