ENGINEERED GOLF PUTTER FITTING QUESTIONNAIRE Q&A's for client to complete prior to putter fitting session. Customer Name*First NameLast Name Date* Contact Information*We may need to discuss certain points of the fitting information with you. An email address is required to return your fitting information to you.eMail AddressTelephone Number Address*We would need this information if you require your putter to be delivered to you.StreetCityProvince/State/RegionCountryPostal Code/ZIP PUTTER FITTINGPERSONAL INTERVIEWSECTION 1 - STATISTICSPutt Right or Left*Right HandedLeft HandedNumber of Years Playing GolfCurrent HandicapHandicap TrendGoing upStaying LevelGoing DownWhat's your average score?Lowest Score Previous 12 MonthsAverage number rounds played in a year?Have you ever taking putting lessons from a Certified Professional?YesNoIf yes to above, please list approximately when and what you covered.Do you practice putting before playing?AlwaysRegularlySometimesNeverDo you ever practice putting just to practice?RegularlySometimesNeverSECTION 2 - PHYSICAL LIMITATIONSDo you have any physical pain when you putt or practice putting?YesNoIf yes to above, please explain.Your Pain Symptoms - Are They?Check all that are applicable. Permanent Temporary Recurring Do you have any other physical limitations that affect your putting?YesNoIf yes to above, please explain.SECTION 3 - PLAYING CHARACTERISTICSPoor Putting TendenciesWhen you hit a poor putt, do you have a specific tendency, Select more than one if necessary Top it Push it Pull it Poor distance control Very inconsistent Don't know Other If other was selected above, please explain.What is your general confidence level with your putter?Very confidentSome confidenceNo confidenceDepends on situationIf you selected "Depends on situation", then please explain.How does the weight of your present putter feel to you?Too heavyWeight OKToo lightDon't knowSECTION 4 - GOALS, WANTS & PREFERENCESMy immediate goal in golf is:Spend a lot of time & energy to improve as rapidly as possibleSpend a reasonable amount of time & effort to improveCan only spend a little time but want to improveJust want to find out if my putter is right for meMy future goal regarding my handicap is to be:A scratch handicap (72)A low handicap 1-8 (73-82)A middle handicap 9-15 (83-89)An average golfer 16-22 (90-98)Don't knowPersonal WantsFrom your own point of view, check off any personal wants that apply. Check as many as you like, but only if you feel you have a problem in that area. I want better distance control I want better directional control I want to stop pushing the putt I want to stop pulling the putt I want to putt the ball with more consistency Any other wants, please explain.Personal preference in putters.Do you have a strong preference in the type of putter and its characteristics? Multiple choices are possible. Heel shafted Mid-heel shafted Center shafted Blade Mallet Do you have personal preferences in grips? If yes, please list.SECTION 5 - CURRENT PUTTER SPECIFICATIONSWhat is the brand of the current putter you play?What is the model of the current putter you play?What is the loft of the current putter you play?What is the playing length of the current putter you play?What is the swingweight of the current putter you play?What is the grip on the current putter you play?Any additional information you would like to add?CommentsThis field is for validation purposes and should be left unchanged.