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* 1. What is your gender?

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* 2. How old are you??

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* 3. How long have you been married?

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* 4. Would you say you are a Christian/Follower of Jesus?

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* 5. For this survey, porn use is defined as repeated, intentional, solo viewing of pornography.

Rate how hurtful/harmful/destructive each of the following is. Zero is not hurtful/harmful/destructive, 1 is just a bit, 7 is the worst.

  0 1 2 3 4 5 6 7
Committing adultery
Going to a strip club
Intentionally lusting after people in public
Looking at porn without masturbation
Looking at porn and masturbating
Hiding/lying about porn use

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* 6. Do you think people can be addicted to porn?

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* 7. Do you think you are addicted to porn?

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* 8. Optional Comments

T