Email The Purity Report OLD

Your Name:

Enter Your Email Address:

Enter Your Friends Email Address (separate multiple addresses with a comma):

When was your last Purity Report?

What period of time does this Purity Report cover?

Be as detailed as possible without being graphic or vulgar. Avoid copy-and-pasting responses.


Briefly list any sexual release or arousal you experienced and the source of that stimulation.

Describe any exercise or other healthy physical activity you engaged in.

Soul (Mind, Will and Emotions)

Briefly list any sexually oriented thoughts you encountered.

Describe any choices you made which resulted in a violation of sexual integrity.

What influenced those choices?

Describe any strong emotions, both negative and positive, you experienced.

Have you been feeling emotionally numb, distant or withdrawn?

What stressful or negative situations are you dealing with or hiding from?


Describe any interaction you had with the Lord. List specific scripture references from time in the Word of God.

Has God felt distant or close?

What do you believe influenced that feeling?

What are you thankful for today?

List any guidance or intervention you need from God.


Have you been completely honest and forthcoming with your answers?

Are you sharing your Purity Report with someone you know personally?

What else would you like to add to this report?

STOP: Take a minute to pray over your responses.
Bring this confession to God first.
Then send it to your accountability friends.

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Scripture for Further Reflection

But the fruit of the Spirit is love, joy, peace, patience, kindness, goodness, faithfulness, gentleness, self-control; against such things there is no law. (Galatians 5:22-23)

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