1. Height ______ Weight _______ Age ______ 2. Wrist to Floor Measurement. - Stand comfortably erect in flat shoes, shoulders perfectly level, arms hanging relaxed at your sides and measure the distance from the major crease in the wrist at the base of the palm of your lead swing hand in inches and fraction of inches (left hand for Right Hand players). Record the measurement below.
Inches ________________
3. Physical Strength (as compared to others of your age) - Below Average _______ Average _______ Above Average ________
4. Athletic Coordination Ability (as compared to others of your age) - If you struggled to be competent in most athletic sports ckeck Below Average_____; If were a better athlete but not among the best check Average _____; If you were a standout in most sports you participated in check Above Average _____.
5. From the diagram below, please check the one that best describes you posture. 
6. Do you play Right Handed _______ or Left Handed _______. 7. What is your Handicap Index. (circle one) <6.9 7 to 12.9 13 to 18.9 19 to 24.9 25 to 31.9 > 32
8. If no Handicap, please provide your average score for 18 holes. __________ 9. Average number of Fairways hit per 18 holes (out of 14 potential driver/tee shot holes.) _________ 10. Average number of Greens hit in regulation per 18 holes. (1shot/par 3; 2 shots/par 4 & 3 shots/par 5 __________/18 holes 11. Average number of putts/18 holes _______. 12. How many 9 hole Rounds ______ and 18 hole Rounds ______ do you play/month. 13. How many times do you practice at a Range/month ________ 14. Please mark the box near the image that best describes you swing plane. 
15. Please describe the Force and Intensity with which you typically begin the downswing. 
16. Please describe your overall swing tempo for full shots with woods and irons. 17. Looking at the illustrations below, which one comes closest to your Wrist Cock Release position. Please provide a Video of your swing from a position behind the Golfer at 15 feet and a second looking at the Golfer from the side at a distance of 15 feet. Circle the most appropriate.  18. Do You have any physical discomforts when you play. Hand pain or discomfort with the grip _____ Arm, elbow, shoulder, joint pain from impact with the ball ______ Back Pain when you swing or hit the ball ______ Other, decribe ______________________________________________________________________
19. What is you most typical swing path? In side to Outside _____ Square _____ Outside to Inside _____ Don't Know _____
 20.What is your Driver Trajectory/Height Low - Lower than most Golfers (height of 20 yds. or lower on launch monitor) Medium - about the same as most other golfers (around 27 to 33 yds on Launch Monitor High - Higher than most Golfers (above 35 yds on launch monitor)
21. What is your Clubhead Speed. ________ How was it measured and with what measuring device. ______________________________________ 22. What is your average carry distance with a 5 iron _______ Driver _______ 3W ______ 5W ______ 23.What is your typical Vertical Impact position on a Driver _______ Fairway Wood _______. 
24. What is your typical Horizontal impact position on your Driver _______ and a Fairway Wood ______. 
25. What is your Predominany shot pattern for your Driver _______ Fairway Wood _______ 
26.What is the loft of your current Driver. ________ deg. Has the Driver ever been checked for loft on a Spec. Gauge. Yes/No If Yes, what was the actual loft _______ deg. 27. What is your predominant game improvement goal for your Driver and Fairway Woods 28. What is the longest iron you hit solid and on center on a consistent basis. _________iron 29 When you hit the ball off center with a iron, what is your location tendency? ________ 
30 What is the normal flight path of your irons? ________
31. What is the swing speed of your 5 iron or 7 iron _________ mph 32. If you are unsure of your swing speed, what is the carry distance of your 5 iron shot _____ yds. or 7 iron shot ______ yds. 33. Is hitting the ground (fat shot) a frequent or on/off problem with your irons. Yes ______ No _______ 34. Wht is your predominant game improvement goal with your irons. 35. What is your preference on the Head size of the Driver. Very Large - 440 to 460 cc _____ Large - 420 to 440 cc _____ Medium - 380 to 420 cc _____ No Preference _____
36. What is your preference for the Driver Head Shape. 
37. What is your Iron size, offset & head type preference. 
  38. What is your Iron Sole Design Preference. I prefer a WIDE Sole _____ I prefer a MEDIUM WIDE Sole _____ I prefer a NARROW Sole _____
39. What is your preference of Iron Head Material. 40. What is your preference of Shaft material in the following (Enter Graphite or Steel or No Preference). Driver ____________________________ Fairway Woods _____________________ Hybrids ___________________________ Irons _____________________________ Wedges __________________________
41. What is your preference for the Impact Feel in your Woods. I like the feel of a little more flexible or softer feel of the shaft _____ I like a very stiff feel with a more rigid impact feel of the shaft _____ I like to have some impact feel of the shaft _____ No preference if it helps my game _____
42. What is your preference for the Impact Feel in your Woods. I like the feel to be a little softer at impact but not mushy _____ I like a stiffer impact feel at impact but not overly harsh _____ I like to have some impact feel of the shaft _____ No preference if it helps my game _____
43. What is your preference for the Impact Feel in your Irons. I like the feel of a little more flexible shaft at impact _____ I like the feel of a little more rigid shaft at impact _____ I like to have some impact feel of the shaft _____ No preference if it helps my game _____
44. What is your preference for the Impact Feel in your Hybrids. I like a little more flexible impact feel of the shaft _____ I like a very stiff feel of the shaft at impact_____ I like to have some impact feel of the shaft _____ No preference if it helps my game _____
45. Do you have a Grip Material/Composition preference. Rubber _____ Synthetic _____ Rubber/Cord _____ Synthetic Cord _____ Arthritic _____
46. If you know your grip size, please list here, e.g. +1/64 oversize. _____________ and do you prefer any additional wraps under the lower hand. (recommended: 1 additional lower hand wrap for each +1/64" oversize. e.g. Grip is +1/32 - add two additional lower hand wraps) 47. Please enter any additional Comments below. |