Client Information

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

FIRST Name *

Last Name *

Phone *

date of birth *

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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