STUDENT PROFILE QUESTIONNAIRE

To help prepare for your New Student Assessment, please fill out and submit the questionnaire. NOTE: We take student privacy very seriously. Information will be used by Skip Guss and the student ONLY.

Time to complete questionnaire: 4 min

Student Profile

Adult (17+) or Youth (16 & under) *
Are you right handed or left handed? *

Golf Game Assessment

Rate your game (as honest as possible). On a scale of 1–10, eg. 1=Low/Poor, 5=Intermediate/Fair, 10=High/Excellent and anything in between

If you miss-hit a shot, what is the tendency?
Check all that apply
Do you have any physical restrictions (that are you willing to share)? *
What equipment would you like assistance with (select all that apply):

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