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Student Questionnaire
Student Questionnaire Form
Contact Information
Name
*
Email
*
Golf Game Questions
What is your current handicap or average round?
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What is your average number of rounds played per week?
Average number of hours spent practicing per week?
What is your current natural ball flight?
Describe your ball flight on poor shots?
On a scale of 1-10 rate the average solidness of your ball striking
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Where on the clubface are the majority your poor strikes located (Centered, Heel Toe)?
What is your 7 iron club distance?
What is your driver distance (Carry Distance)?
On a scale of 1-10 rate your short-iron play
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On a scale of 1-10 rate your driving
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What do you personally feel are your playing strengths?
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What do you personally feel are your playing weaknesses?
Physical Information
How would you rate your flexibility on a scale of 1-10 in the ability to turn your chest and shoulders while keeping your hips and legs in a stationary position
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Have you had any previous injuries that have resulted in physical limitations? If so, please list
Are you right-eye dominant or left eye dominant?
How would you rate your overall flexibility on a scale of 1-10:
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How would you rate your ability to rotate your hips while keeping your torso and upper body in a stationary position by holding it with your hands?
Is there anything physical that you feel affects you play negatively in any way?
Final Question
What do you want to achieve from this on-line lesson?
Approaches
Communication & Learning Styles
Mental Playing & Competitive Development
Ball Striking Development
Short Game Development
Putting Development
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