On behalf of Donny Epstein and the EpiEnergetics family, CONGRATULATIONS on your decision to experience the EXTRAORDINARY! YOUR INPUT IS IMPORTANT The answers you provide on this form are invaluable to EpiEnergetics and Donny Epstein in the preparation to best serve you. Thank you for your part in creating an experience like no other! Name* First Last Email* Event Location*How did you hear about this experience?* Received Mailer Received Email Previous Program Website Facebook Friend Other What was the tipping point for you deciding to come to this experience?*What would you like to take home from the experience?*Which Energetic Intelligence would you like to be more energized for more effortless living? (needs more energy and difficult) (choose one)* Bioenergetic: organizes body structures, available energy, sense of survival and instinct, organizes bones, ligaments, connective tissue, skin, blood vessels etc, sense of constancy. Emotional Energetic: organizes body posture, long muscles and tendons, immune system, white blood cells, immediate reaction to changing environment or situations, free and effortless expression of emotion. Lower Mental Energetic: conditioned thinking, culture, boundaries, simple mental focus on things, events, locations, words and routine tasks, rules. Upper Mental Energetic: executive functioning, complex thinking, optimizing things, finding the best way, understanding concepts and maps of your life, finding new options, your life path or values. Soul Energetic: experiencing beyond thinking, time and space dissolve, experience of effortless, love, gratitude, experiencing the energy of creation and love within or around things and the body, wanting and doing the “right thing” just because. Universal Spirit Energetic: experiencing grace, the networking of people, events and timing, synchronicity. Finding the gift in most things and people. Which Energetic Intelligence does it seem is easily energized and accessible? (abundant in energy and easy) (choose one)* Bioenergetic: organizes body structures, available energy, sense of survival and instinct, organizes bones, ligaments, connective tissue, skin, blood vessels etc, sense of constancy. Emotional Energetic: organizes body posture, long muscles and tendons, immune system, white blood cells, immediate reaction to changing environment or situations, free and effortless expression of emotion. Lower Mental Energetic: conditioned thinking, culture, boundaries, simple mental focus on things, events, locations, words and routine tasks, rules. Upper Mental Energetic: executive functioning, complex thinking, optimizing things, finding the best way, understanding concepts and maps of your life, finding new options, your life path or values. Soul Energetic: experiencing beyond thinking, time and space dissolve, experience of effortless, love, gratitude, experiencing the energy of creation and love within or around things and the body, wanting and doing the “right thing” just because. Universal Spirit Energetic: experiencing grace, the networking of people, events and timing, synchronicity. Finding the gift in most things and people. Which of the following describes your current state? Select only your top 3 then enter those statements in order 1-2-3, in the fields below. br> br> Note: You may copy and paste your choice into the box next to its priority for you, or you may type your choice. Please choose from the following list of options: It seems like nothing works. It seems like it will never end. I want to get rid of this painful situation. I find the need to find cause. I feel stuck (or blocked) and am being held back. It is time I take my power, life and/or health back. I am willing to peel back my illusions, stories, rules, and beliefs and be with whatever is there to find what is real. I will do whatever it takes as I am so ready. I can feel and sense the next level. I accept what has happened, and am ready for resolution. I realize these patterns once served me, and are now outworn and no longer welcome. I feel grateful for what has happened and will happen. I am very blessed. I realize that we are all connected, and everything is purposely organized. I look for the gift even in the pain. My Number 1 Choice:*My Number 2 Choice:*My Number 3 Choice:*How would you like your energetics and overflow of energy and organizing wisdom to impact your life? The lives of others?*THANK YOU FOR SHARING! We look forward to providing you with an Extraordinary Experience! Please click the "SEND" button below to provide us with your valuable information.