Energize Shanti

The first step to explore a Body Current® and/or Energize private session is to complete this short assessment below.  PLEASE ONLY CLICK “send your info now” ONCE although you will not receive a message saying your assessment was sent, it has been sent to Shanti and her team.

    Full Name:
    Phone Number:
    Email Address:
    Date of Birth:

  1. Have you experienced any of the following during the past 6 months?
    (Select all that apply) Dizziness Shortness of breath Nausea Pain in your chest area Pain in any of your joints Muscular pain Surgery

  2. What are your personal health and fitness goals?

  3. What exercises/activities do you currently enjoy? Hiking Biking Cycling Yoga Weight Training Swimming Pilates / Core work

  4. On a scale of 1 (very little) to 10 (a lot), what would you say your stress level is on average?

  5. Have you suffered any injuries or trauma in the last 6 to 12 months?

  6. On most days do you feel:

  7. Any other questions or comments?