Golf Assessment Form

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Home Course
Teaching Professional
Identify Swing Faults
S-Posture
C-Posture
Loss of Posture
Flat Shoulder Plane
Flying Elbow
Early Extension
Over-the-top
Sway
Slide
Late Buckle
Reverse Spine Angle
Forward Lunge
Hanging Back
Casting
Scooping
Chicken Wing
Other
Briefly describe any pain experienced during or following a round of golf
When did this pain begin?
Since this pain began, it is...
Describe the quality of your golf related pain
Sharp
Dull
Throbbing
Burning
Achy
Stiff
Average Pain Intensity
In what Phase of your swing does the pain occur?
Address
Backswing
Downswing
Acceleration/Impact
Follow-through
Please select one statement that most closely applies to you
I experience no pain while playing golf
I experience pain but it does not prevent me from playing golf as often as I like
Because of my pain, my golf play is decreased by 25%
Because of my pain, my golf play is decreased by 50%
Because of my pain, my golf play is decreased by 75%
Pain prevents me from playing any golf
Handicap
Golf Related Goals
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