Client Information

After Scheduling your Lesson, please provide the below information so your Instructor can build your customized profile for your program.

Remember to fill out this form only After you've scheduled your lesson.

FIRST Name *

Last Name *

Phone *

date of birth *

Email (Same as booking email) *

Are you suffering from a medical condition, illness, or injury? *

NoYes

Gender *

MaleFemale

Are you a left-handed or right-handed golfer? *

Left HandedRight Handed

Weight (in pounds) *

Height (Feet & Inch) *

Do you have any physical limitations your Instructor needs to be made aware of? *

NoYes

If you answered yes to any question, please elaborate:

What type of Golfer are you? *

BeginnerWeekend EnthusiastCompetitive

What would you like to improve about your golf game and/or what do you think you struggle with most?

How did you hear about UGRx? *

Facebook/InstagramGoogle AdFriend/ReferralHaas Family GolfOther

I declare that the info I’ve provided is accurate & complete. *

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New Client Special

1.5 Hour Booking

1.5 Hour Lesson

1 Hour Booking

1 Hour Lesson

30 Min Booking

30 Minute Follow Up Lesson *Existing Clients Only*

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