Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.This will take you about 5 minutes to complete. Pour your heart into answering each question (but without being too explicit and without uncovering ANYONE else's sins, just as you wouldn't want anyone revealing things about you to others). "Confess YOUR faults one to another, and pray one for another, that YOU may be healed.” James 5:16 “If we confess OUR sins, He is faithful and righteous to forgive us OUR sins and to cleanse US from all unrighteousness.” 1John 1:9 Rest assured: Everything you share is strictly and absolutely confidential. Name *FirstLastEmail *Please make sure you fill this out carefully so that we can contact you.I am: *MaleFemaleIf you are female, please visit HopeAtLast.com.Country *What languages do you speak? *List all the languages you speak, separated by a comma, starting with your Home Language.I'm here: *Seeking restoration for my marriage.Seeking restoration for my current relationship.Seeking healing for myself—I am NOT interested in restoring any relationship.What is your current marital status? Please be sure to choose the one that BEST describes your situation. *Married and my wife lives with me.Separated: I am married, but my wife does not live with me.Divorce filed and my wife lives with me.Divorce filed and my wife does NOT live with me.Divorced.Never legally married and I want help.Wife has remarried.I have experienced a Restored Marriage.Have you read the book "How God Will Restore Your Marriage" *YesNoHow did you find our ministry? *Now, please tell us about your situation and why you have come to us for help and what has your wife/partner say is the main issues or problems she has with you and your relationship?Please use the space below to simply speak to God, in your own words, pouring your heart out to Him.In order for us to minister more effectively to you, please check what concerns apply to you:Custody issues.Suicidal.DepressedAbused or molested as a child.Fallen into adultery, need help.Thankfully I have no other concerns other than my relationship at this time.Submit Please leave this field emptywww.encouragingmen.org Stay Encouraged Blog! Sign up to receive awesome content in your inbox, every week on Monday. Email Address * !!Please remember to check your inbox or spam to confirm your subscription!! We don’t spam!! Check your inbox or spam folder to confirm your subscription.
