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:
    Occupation:

  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
    Comments:

  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
    Other:

  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?