Secrets of Champions™

First Name

Last Name

General Level of Play

How would you rate your present level of play in general?

1 10

5

How would you rate your present effort level in working toward improving your overall game?

1 10

5

How would you rate your willingness to work harder in bettering your overall game?

1 10

5

Skill Development

How would you rate your present putting ability?

1 10

5

How would you rate your present effort level in working toward improving your putting?

1 10

5

How would you rate your willingness to work harder in bettering your putting?

1 10

5

How would you rate your present chipping ability?

1 10

5

How would you rate your present effort level in working toward improving your chipping?

1 10

5

How would you rate your willingness to work harder in bettering your chipping?

1 10

5

How would you rate your present pitching ability?

1 10

5

How would you rate your present effort level in working toward improving your pitching?

1 10

5

How would you rate your willingness to work harder in bettering your pitching?

1 10

5

How would you rate your present iron play ability?

1 10

5

How would you rate your present effort level in working toward improving your iron play?

1 10

5

How would you rate your willingness to work harder in bettering your iron play?

1 10

5

How would you rate your present ability to hit a fairway wood?

1 10

5

How would you rate your present effort level in working toward improving your fairway wood play?

1 10

5

How would you rate your willingness to work harder in bettering your fairway wood play?

1 10

5

How would you rate your present ability to get off the tee?

1 10

5

How would you rate your present effort level in working toward improving off the tee?

1 10

5

How would you rate your willingness to work harder in bettering yourself off the tee?

1 10

5

How would you rate your present ability to manage the course?

1 10

5

How would you rate your present effort level in working toward improving your course management?

1 10

5

How would you rate your willingness to work harder in bettering your course management?

1 10

5

How would you rate your present ability to estimate shot distance?

1 10

5

How would you rate your present effort level in working toward improving your shot distance estimations?

1 10

5

How would you rate your willingness to work harder in bettering your shot distance estimations?

1 10

5

How would you rate your present ability to strategize in match play?

1 10

5

How would you rate your present effort level in working toward improving your match play strategies?

1 10

5

How would you rate your willingness to work harder in bettering your match play strategies?

1 10

5

How would you rate your present ability to shape your shots?

1 10

5

How would you rate your present effort level in working toward improving your shot shaping?

1 10

5

How would you rate your willingness to work harder in bettering your shot shaping?

1 10

5

Situational and Game Awareness

How would you rate your present level of situational and game awareness?

1 10

5

How would you rate your present effort level in working toward improving your situational and game awareness?

1 10

5

How would you rate your willingness to work harder to achieve your peak situational and game awareness?

1 10

5

Strength and Conditioning

How would you rate your present strength and conditioning?

1 10

5

How would you rate your present effort level in improving your strength and conditioning?

1 10

5

How would you rate your willingness to work harder in bettering your strength and conditioning?

1 10

5

Injury Prevention

How would you rate your present ability to prevent injuries?

1 10

5

How would you rate your present effort level in improving your ability to prevent injuries?

1 10

5

How would you rate your willingness to work harder toward preventing injuries?

1 10

5

Energy Management

How would you rate your present ability to manage your daily energy?

1 10

5

How would you rate your present effort level in managing your energy throughout the day?

1 10

5

How would you rate your willingness to work harder in bettering your energy management?

1 10

5

Nutrition

How would you rate your current nutritional habits in helping you achieve success?

1 10

5

How would you rate your present effort level in maintaining healthful nutrition?

1 10

5

How would you rate your willingness to work harder toward better nutrition?

1 10

5

Sleep, Repair and Recovery

How would you rate your current sleep habits in helping you achieve success?

1 10

5

How would you rate your present effort level in bettering your sleep?

1 10

5

How would you rate your willingness to work harder in bettering your sleep?

1 10

5