ON LINE LESSON Questionnaire
I realize there are a lot of questions here. That’s because I want to do as good a job as possible in helping you!
Please answer what you can. Use N/A if you don’t know
The more information I get the better
Natural Hand Usage—(eating, throwing,—L/R/Ambidextrious)______
Putt LH or RH______
Beliefs (SBST, ARC, INSIDE TO INSIDE, OTHER______
Putting Instruction in the Past?______
With Whom______Likes/Dislikes______
How Often______When?______
Email______
Phone______
Avg. Score or Handicap______
Avg. Rounds per year______
# Years playing______
List any putting stats of yours______
Putting Goals______
Typical Miss (R or L)______
Typical Miss (Short or Long)______
Rate yourself 1(Poor) to 5(Great)
Speed/Distance Contol______
Short Putts(4’ or less)______
5’ to 12’______
Green Reading______
How many hours per week of putting practice______
Putting training aids you use (list)______
Was your putter fit for you?______Where?______
What is length of your putter?______
How many inches from your crease in your wrist to floor with arms hanging down?______
What Brand/Model Putter do you use the most?______
Grip type and size______
How many putters do you own?______Use?______
Tend to Decelerate, Overaccelerate or about right?______
Do you have the yips often, always, rarely or never?______
If so are they on short putts, long putts, all putts?______
Putting styles of gripping used (Yes or No)
Standard______
Opposite hand Low?______
Claw______
Thumbs side by side______
Other______
Green Reading (Yes or No)
AimPoint Express ______
Eyes/Visual from behind the ball______
Eyes/Visual from behind the hole______
Eyes/Visual from the side______
AimChart______
Experience playing the course______
Guess______
Do you consider yourself a good green-reader?______
Imagery, mental and visual
Do you see a curved line where you expect the putt to roll on?______
Do you visualize the putt going in the hole?______
Positive or Negative before putting?______
Don’t have any thoughts______
What is the weight balance between L and R Feet? (50/50, 60/40 front, etc.______
Where do you feel you are balanced from toe to heel?______
Do you use a forward press?______
If so is it a trigger to take the putter back?______
Do you have another trigger to take the putter back?______
Ball Position 0-10 (0 = ball even with front foot, 5= Middle of stance and 10= ball even with back foot)______
Do you grip down on the putter?______How much?______
Breathing
Exhale/Inhale?______
Hold Breath______
Nothing Conscious______
Other______
Been on SAMPUTT before?______
Been on Tomi before?______
Blast Motion?______
Quintec?______
Results on any of them______
(please email reports if you have them.)
Do you use a line on the ball aimed at the target? ______
See a curve when you putt or aim at a spot?______