First Name
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Last Name
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Phone
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Email
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What was your game like at your best? (handicap, events you played, strengths)
Current handicap or average score
What does a typical round look like now, and where do you lose the most shots?
Do you play in competitions? Which ones, and how often?
List each surgery or major injury (body area and approximate year)
Has your doctor given you any movements to avoid or limits to work within?
Where do you feel pain or stiffness during or after a round, if anywhere?
Has your doctor cleared you for full golf activity?
What do you notice most about your swing right now? (timing, power, contact, ball flight)
Which clubs feel the hardest to hit well right now?
What would playing better look like for you over the next 6 months?
How often do you play and practice each week right now?
Anything else I should know before we start?
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