Braving Hope Call Please complete the questions below to help us use our time well to serve you on the call. Name* First Last Email* Phone*International Callers: If you are located outside of the United States, please include the Country Code + Area Code (if any) + Phone Number.Please describe the current challenges you are dealing with in your life individually and your relationship as a result of betrayal:*Please describe (in the most specific way you can) what you want to see change in your life/relationship and what your life will look like after this change:*What is the single biggest obstacle to you achieving the life you described above?*Additional DetailsPlease help us better understand the dynamics of your current relationship and how you think PartnerHope can be most helpful.Briefly describe the betrayal issue that you are dealing with in your relationship: Sexual addiction? Infidelity without a compulsive component? Pornography addiction? Other?*Check all of the following that apply to your situation:* I have not done therapy or sought help Discovery of the betrayal occurred within the past 90 days. I have completed a Full Therapeutic Disclosure process with a trained therapist. I am in individual therapy or are in couple’s therapy. I spend more than 3 hours each week participating in recovery-related activities. My significant other has over 3 months of sexual sobriety (if still in your relationship). Right now I… (pick the one that is most true for you)* I have the time, emotional and financial resources to invest in healing myself. I have access to the time, emotional and financial resources to invest in my healing but am ambivalent about doing the work. I don’t have the time, emotional or financial resources to invest in healing myself. If someone asked me to commit to spend five hours of dedicated time each week working to heal from betrayal and transform my life I would…(pick the one that is most true for you)* Commit and do it as my first priority because I absolutely know that level of time and attention is required to heal from betrayal and rebuild my life Say I would do it, but other priorities would likely crowd it out and it wouldn’t happen. Tell myself I can still heal without investing that kind of time and attention. Our team will call you at the time you chose. Please commit to your appointment by typing this sentence in the box below: “Yes, I promise I will answer the phone for my ‘hope’ call when PartnerHope calls”* PhoneThis field is for validation purposes and should be left unchanged.
