Uncommon Man Project

Welcome. This form helps your coach understand where you're at so we can make the most of our time together. Take your time — be honest, it's just for us.

1

Personal Details

2

Business & Career

3

Health & Lifestyle

ChillHyper Stressed
4

Wheel of Life — Rate Each Area (1–10)

1 = rock bottom, 10 = exactly where you want it

5

Intimacy & Relationships

6

Coaching Goals & Vision

7

Psychology & Identity

Not At AllVery Committed
8

Deep Reflection

This section goes deep. Take your time. There are no wrong answers — only honest ones.

No clarityCrystal clear
9

Additional Context

10

Attachment Style

For each statement, select the column that best describes how you feel — A, B, or C. Pick the one that fits most naturally, even if none feels perfect.

Adapted from Fraley, Waller & Brennan's ECR-R Questionnaire, as used in Attached by Dr Amir Levine & Rachel Heller.

TRUE
ABC
I often worry that my partner will stop loving me.
I find it easy to be affectionate with my partner.
I fear that once someone gets to know the real me, s/he won't like who I am.
I find that I bounce back quickly after a breakup. It's weird how I can just put someone out of my mind.
When I'm not involved in a relationship, I feel somewhat anxious and incomplete.
I find it difficult to emotionally support my partner when s/he is feeling down.
When my partner is away, I'm afraid that s/he might become interested in someone else.
I feel comfortable depending on romantic partners.
My independence is more important to me than my relationships.
I prefer not to share my innermost feelings with my partner.
When I show my partner how I feel, I'm afraid s/he will not feel the same about me.
I am generally satisfied with my romantic relationships.
I don't feel the need to act out much in my romantic relationships.
I think about my relationships a lot.
I find it difficult to depend on romantic partners.
I tend to get very quickly attached to a romantic partner.
I have little difficulty expressing my needs and wants to my partner.
I sometimes feel angry or annoyed with my partner without knowing why.
I am very sensitive to my partner's moods.
I believe most people are essentially honest and dependable.
I prefer casual sex with uncommitted partners to intimate sex with one person.
I'm comfortable sharing my personal thoughts and feelings with my partner.
I worry that if my partner leaves me I might never find someone else.
It makes me nervous when my partner gets too close.
During a conflict, I tend to impulsively do or say things I later regret, rather than be able to reason about things.
An argument with my partner doesn't usually cause me to question our entire relationship.
My partners often want me to be more intimate than I feel comfortable being.
I worry that I'm not attractive enough.
Sometimes people see me as boring because I create little drama in relationships.
I miss my partner when we're apart, but then when we're together I feel the need to escape.
When I disagree with someone, I feel comfortable expressing my opinions.
I hate feeling that other people depend on me.
If I notice that someone I'm interested in is checking out other people, I don't let it faze me. I might feel a pang of jealousy, but it's fleeting.
If I notice that someone I'm interested in is checking out other people, I feel relieved — it means s/he's not looking to make things exclusive.
If I notice that someone I'm interested in is checking out other people, it makes me feel depressed.
If someone I've been dating begins to act cold and distant, I may wonder what's happened, but I'll know it's probably not about me.
If someone I've been dating begins to act cold and distant, I'll probably be indifferent; I might even be relieved.
If someone I've been dating begins to act cold and distant, I'll worry that I've done something wrong.
If my partner was to break up with me, I'd try my best to show her/him what s/he is missing (a little jealousy can't hurt).
If someone I've been dating for several months tells me s/he wants to stop seeing me, I'd feel hurt at first, but I'd get over it.
Sometimes when I get what I want in a relationship, I'm not sure what I want anymore.
I won't have much of a problem staying in touch with my ex (strictly platonic) — after all, we have a lot in common.
0
A — Anxious
/ 14
0
B — Secure
/ 14
0
C — Avoidant
/ 14
Your attachment style:
11

Braverman Assessment — Part 1: Nature

Instructions: Score each statement honestly based on how you generally are — not how you'd like to be.

0 = Never or Rarely  |  1 = Sometimes  |  2 = Often or Always

Your Nature Scores (live)

Dopamine
0
Acetylcholine
0
GABA
0
Serotonin
0
Dominant Neurotransmitter
Complete questions above
12

Braverman Assessment — Part 2: Deficiency

Rate how often you experience each symptom or feeling.

0 = Never or Rarely  |  1 = Sometimes  |  2 = Often or Always

Your Deficiency Scores (live)

Dopamine
0
Acetylcholine
0
GABA
0
Serotonin
0

0–5 = Low  |  6–13 = Moderate  |  14+ = High deficiency

Once submitted, your coach will have everything they need before your first session.
Your profile will be stored securely in your client file.

You're in. Welcome.

Your onboarding has been received. Your coach will review everything before your first session together.

Talk soon.