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Pre-Assessment Survey
Name
First
Last
Have you taken lessons before
Yes
No
What did you like or dislike from your past lessons?
Have you played a round of 9 holes or more before?
Yes
No
How many rounds of 9 or 18 holes did you play last year?
A good guess is fine if you don't know exactly
How many of your rounds where played at Mount Si Golf Course?
What is your handicap (if you have one) or average score?
If using average score please specify if its a 9 hole or 18 hole average
How would you rank your Driving?
Poor
1
2
3
4
5
Good
How would you rank your Iron shots?
Poor
1
2
3
4
5
Good
How would you rank your Chipping?
Poor
1
2
3
4
5
Good
How would you rank your Pitching?
Poor
1
2
3
4
5
Good
How would you rank your Bunker Play?
Poor
1
2
3
4
5
Good
How would you rank your Putting?
Poor
1
2
3
4
5
Good
Do you have any physical limitations from injury or motion problems?
Main areas of concern for golf are back, hips, shoulders, arms & hands, but let us know of anything you think your instructor should be aware of.
Would you like to learn more about the rules of golf?
Yes
No
Would you like to learn about navigating the golf course?
Yes
No
This could include how to make a tee time, what tees to use, basics of course etiquette and anything else about getting around a golf course.
What are your golf goals?
