Golf Questionnaire First Name* Last Name* Email* How often do you golf?* Every day Once a week 2 to 3 times a week Once a month 2 to 3 times a month Less than once a month Present Handicap*Ideal Handicap*Have you been fitted correctly for your clubs?* Yes No Do you work with a golf pro on form?* Yes No Do you have any golf related injuries?* Yes No Any low back pain on or off the course?* Yes No Do you experience discomfort or pain in your backswing?* Yes No Do you experience discomfort or pain in your downswing?* Yes No Please list any discomfort, pain or golf related injuries along with ant treatment plans you have tried in the past.*Other Comments / Questions* Δ
