The Grounded Man — EndorFitt

01Who you are

First Name*

Last Name*

Email Address*

WhatsApp Number*

City & Country*

Age

Current relationship status

Where are you based?

How did you find EndorFitt?

02Where you are right now

In your own words — what's actually going on?*Smita has heard everything. There is nothing here that will surprise or judge her.

How much is this affecting your daily life and functioning?1 = I'm managing okay · 10 = it's affecting everything

1 — Occasional inconvenience10 — Can barely function

How long have you been carrying this?

03Your inner world

Which of these describe your inner experience? Select all that apply.True

I convert painful feelings into productivityI haven't cried in years — not because things are fineI perform being okay — no one knows what's actually happeningI'm angry more than I'd like — not always sure at whatI isolate when things get hardI've stopped asking for help — it doesn't feel availableI don't know what I actually feel — it's all just pressureI've been carrying something specific that I've never told anyoneI know something needs to change but I don't know what or how

Describe your inner world right now. What's actually running in the background?The more honest you are here, the better Smita can meet you where you actually are.

When did you last feel genuinely like yourself?

Is there something you've been keeping quiet — something nobody knows?This is private. Only Smita will read this.

04Physical and lifestyle

What's your body like right now? Select all that apply.True

How much physical activity right now?

Stress level on a typical day:

05The 101-day programme

What do you want from The Grounded Man? Select all that apply.True

To understand why I keep ending up in the same placeTo talk to someone who won't pity me, fix me, or judge meTo address what I've been carrying alone for yearsTo rebuild identity after divorce or relationship lossTo find out who I am when I'm not in a roleTo actually feel something — not just manageTo stop the patterns that keep recreating the same painA system — checklists, accountability, goals I can actually measureTo work on the physical and mental together, not separately

What is the single most important thing you want from this programme?*

If this worked exactly as you hoped — what would your life look and feel like at the end of 101 days?

How ready are you to do the real work — including the parts that are uncomfortable?There is no right answer. If you're not ready yet, that's still a starting point.

1 — Not ready yet10 — Completely ready

06Background

Previous experience with therapy, coaching, or counselling:

What has stopped you from doing this work until now?This helps Smita understand the starting point.

Anything else you want Smita to know before your first session?

07Practicalities

Preferred session format

Preferred session time (IST)

Your timezone

You're still showing up
everywhere you're supposed to.
But where are you?

Application received.

Ready to begin?

You're still showing upeverywhere you're supposed to.But where are you?

Application received.

Ready to begin?

You're still showing up
everywhere you're supposed to.
But where are you?