Form

General Information

Help us get to know you better to enhance your clinic experience.

Disability / Impairment *

To your knowledge, do you need/use any adaptive equipment?

We provide clubs and adaptive equipment based on need. Do you own clubs?

Yes, bringing clubs.

No, will need clubs.

Level of Golf Experience

Beginner

Intermediate

Advanced

Will you be bringing any guest with you?

Yes

No

If yes above, please list their name and relationship to you.

Additional Comments/Other Information We Should Know About You