Please answer the questions as openly and honestly as you feel comfortable.
Click the button below to start.
Question 1 of 6
How long have you had the Yips?
Question 2 of 6
Which shots are affected?
Question 3 of 6
Please describe your symptoms and how it affects your game.
Feel free to include your thoughts and feelings about this as well as what is happening physically.
Question 4 of 6
What is your handicap?
Question 5 of 6
How long have you been playing golf?
Question 6 of 6
Please leave your name and email address so I can get back in touch with the details when all applications are in.