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All Access Membership
Practice Plans
Break 70 Golf Program
Break 80 Golf Program
Break 90 Golf Program
My Account
Checkout
Worksheets / Downloads
Video Courses
Facebook Group
Blog
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Fill Out Our Student Questionnaire
Apply to become one of our private online students we give customized one on one coaching and swing analysis to. We will review your application and reach out to you to via email when we open for enrollment. Thanks!
Questionnaire
Gender
Age Range
Under 13
14-17
18-24
25-34
35-44
45-54
55-64
65+
Do You Have Any Limiting Injuries/Flexibility/Soreness?
What is your average 18 holes score?
What is your golf handicap?
What's Your Lowest Score Ever?
How Often Do You Practice Golf?
What Is Your Common Bad Swing Fault?
Sliced
Hooked
Topped
Pulled
Pushed
Weakest Area of Your Game
Driving
Long Iron Play
Short Iron Play
Chipping & Pitching
Putting
Average Driver Distance off of the Tee? (Yards)
Average 7 Iron Distance in Yards
Average Number of Putts Per 18 Hole Round of Golf
Rate Your Driver Skill Level (1 to 10 rating, 1 is bad, 10 is great)
Rate Your Long Iron Skill Level (1 to 10)
Rate Your Mid Iron Skill Level (6 iron, 7 iron, 8 iron) from 1 to 10
Rate Your Short Iron Skill Level (9 iron, PW, SW, GW) from 1 to 10
Rate Your Wedge Game Skill Level 50-100 Yard Shots from 1 to 10
Rate Your Chipping Skill Level 20-50 Yard Shots from 1 to 10
Rate Your Chipping Skill Level from inside 20 yards around the green
Rate Your Putting Skill Level from inside 5 feet
Rate Your Putting Skill Level from 6 feet to 15 feet
Rate Your Putting Skill Level from 15 feet to 30 feet
Rate Your Putting Skill Level from 30 feet and beyond (Lag Putting)
Rate Your Mental Toughness in Pressure Situations from 1 to 10
Describe Your Mental Game Strengths and Weaknesses
Would You Be Interested in Private Online Coaching / Swing Analysis?
First Name
Last Name
What Can We Help You With in Your Golf Game?
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