Golf Student Questionnaire
Rob Krieger Golf Coaching Programs - Red Rock Golf Instruction - Southgate GC, St George, Utah
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Email *
YOUR INFORMATION
Please give us your current basic information about you.
First and Last Name *
Address *
Email  *
Mobile Number  *
Birthdate  *
MM
/
DD
/
YYYY
Occupation/Retired/Student *
Age *
Height *
Male or Female *
Required
Play Golf Right Handed or Left Handed? *
Required
Do you wear glasses when you play golf? *
Required
How did you hear about us? *
DESCRIBE YOUR GOLF GAME
In the following questions, please do your best to give as much information about your golf game so we have a better understanding of how you play and how best for us to help you improve.
Have you or do you play other sports? Please list. *
How often do you PRACTICE Golf/mo? *
How often do you PLAY Golf/mo? *
Where do you PLAY Golf most frequently? *
What do you currently shoot for 18 Holes? *
What is your lowest score you have ever shot? When? *
What yardage do you hit your? DRIVER *
What yardage do you hit your? 5 Iron/5 Hybrid *
What yardage do you hit your? 7 Iron *
What yardage do you hit your? Pitching Wedge *
Please rate the following areas of your game on a scale from 1-5 (1 = weak to 5 =strong) *
1
2
3
4
5
Tee Shots
Putts (< 5ft)
Putts (6-15ft)
Putts (15ft +)
Chipping
Pitch(20-50 yds)
Pitch(50-100 yds)
Bunkers-Greenside (0-30 yds)
Bunkers-Fairway (30+ yds)
Irons
Hybrids
Fairway Woods
Pains by Joint? Please list. *
Recent Surgeries or Injuries ? Please list. *
GOLF GOALS
Please take a moment to think about what you want to achieve with your golf game both measurable metrics likes scores, # of putts, consistency, etc. as well as the mental/emotional side of golf like; more fun, less embarrassment, more confidence, more enjoyment or just to play better with family and friends.
SHORT TERM (60-90-365 days) - What goals do you want to achieve? *
LONG TERM (1 - 5 years) - What goals do you want to achieve? *
Why is it important for you to achieve these goals? *
When you do achieve these goals, what do you think that will feel like? *
The most important question of all: Will you be able to commit yourself 100% to achieving better results and having more success? *
A copy of your responses will be emailed to the address you provided.
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