The Rooted Woman — EndorFitt

01Who you are

First Name*

Last Name*

Email Address*

WhatsApp Number*

City & Country*

Age

Relationship status

Motherhood status

Where are you based?

How did you find EndorFitt?

02Where you are right now

In your own words — what's actually happening?*There is nothing here that will surprise or judge Smita. This is a space where the real thing can finally be said.

How much is this affecting your daily life?1 = I'm managing · 10 = it's running my entire life

1 — A background noise10 — It's everything right now

How long have you been carrying this?

03Your inner world

What does your inner world actually feel like right now?The more honest you are here, the better Smita can meet you where you actually are.

When did you last feel like yourself?

Is there a version of yourself you feel like you've had to give up?This is a question worth sitting with before answering.

04Physical and body

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

Exhausted — tired even after sleepingIn chronic pain (back, joints, tension)Postpartum recovery — body feels differentPCOD / PCOS / thyroid / hormonal issuesWeight changes I haven't been able to addressNot moving much — no time or energy for itDisconnected from my body — I just functionStress eating or emotional eatingGut issues / bloating

Physical activity right now?

05The 101-day programme

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?

What kind of support do you need most?A coach who challenges you? A confidant who listens? Accountability? Structure? Be specific.

How ready are you to do the real work — including the parts that are uncomfortable?If you're not fully ready — that is still a starting point. Smita will meet you there.

1 — Not ready yet10 — Completely ready

06Background

Previous experience with therapy, coaching, or support:

What has stopped you from doing this work until now?

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

07Practicalities

Preferred session format

Preferred session time (IST)

Your timezone

You've been everyone else's.
When does it become yours?

Application received.

Ready to begin?

You've been everyone else's.When does it become yours?

Application received.

Ready to begin?

You've been everyone else's.
When does it become yours?