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Welcome to GuardYourEyes!

To join our website and get access to all the tools and services that we offer, please spend a few moments to fill out the details of this form so we can suggest to you the best possible route of help for your situation. As soon as you've submitted this form, you will get access to our network and be able to contact us to get personalized help.

Dear friend,

please fill out the following form so that we can guide you to the best solutions appropriate for you.

The information will be kept fully confidential. This is a secure form and this information will be used only to help you in your 90-day challenge.

חבר יקר,

על מנת לוודא שתוכנית 12 הצעדים מתאימה עבורך, אנו מבקשים שתמלא את השאלון הבא.

שים לב: כל הפרטים יישמרו בדיסקרטיות מלאה, ולא יועברו לשום גורם בשום מצב.

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The challenge can be different at various ages. That's why it's important that we know how old you are so we can guide you accordingly.
Gender*
For women there is a completely separate system, administrated only by women.
How would you best describe yourself?*
What do you struggle with? (you can select more than one option)*
Often the type of struggle can help determine the solution, especially when the problem is more severe and calls for a different approach. It is therefore important that you describe your situation as accurately as possible.
How long are you struggling with this problem?*
Enter a number between 0 and 365
How would you describe your level of struggle?*
If you're not sure, choose the one that best describes your situation
Are you interested in scheduling a phone meeting with one of our representatives to receive advice and guidance?*
What have you tried so far in attempting to stop?*
Have you spoken to a Rav or a professional? Sworn that you'd stop or put filters on your devices? The more we know about what you've tried, the easier it will be for us to suggest the most appropriate tools for you.
Feel free to write a few words about your background and your situation so we can better guide and advise you. If there is anything significant in your situation that wasn't covered in the questions above, this is the place to tell us.
This will be your Username in our system
Try to choose something easy to remember
Your email will be used for getting in touch with you to help you reach your goal. Your email will be kept absolutely confidential and will not be visible to others.
Not mandatory. The telephone is only for the purpose of consulting and guidance
Are you interested in joining a WhatsApp group to receive daily inspiration?*
Where did you hear about us?
Your initial registration included daily chizuk e-mails called Breaking Free. To also get a second daily email about general Shmiras Einayim chizuk, select the checkbox below.