Let's Get to Know You!

1
How do you currently manage your money?* This field is required.
I only have retirement accounts (such as 401(k), Roth IRA IRT)
I manage my own investments
I use a robo advisor
I work with a financial advisor
I don't know
2
Do you currently have a financial advisor?* This field is required.
YESNO
3
Please tell us why you seeking our services?* This field is required.
I'm unsatisfied with my current advisor.
I am interested in what services FORM Wealth has.
I'd like to get another advisor's perspective.
I have substantial wealth that I'd like to divide with another advisor.
4
How important is it for your financial advisor to have estate planning expertise?* This field is required.
Not Important
Nice to Have
Must Have
5
How important is it for your financial advisor to have tax expertise?* This field is required.
Not Important
Nice to Have
Must Have
6
How important is it for your financial advisor to have insurance product expertise?
Not Important
Nice to Have
Must Have
7
Do you need your financial advisor to be in your immediate area?
Yes
No, I'm comfortable working by phone or video conference
8
When would you like to retire?* This field is required.
1 - 4 years
5 - 9 years
10 -19 years
20 -29 years
30+ years
Already retired
9
Would you like to have an assessment of your retirement readiness?* This field is required.
Yes
Nice to have
Not important
10
Would you like advice on managing your finances in retirement?* This field is required.
YesNot necessary
11
Do you own a business?* This field is required.
YESNO
12
Are you married?* This field is required.
YESNO
13
Name of your Spouse* This field is required.
First Name
Last Name
14
How are you saving with your spouse?* This field is required.
JointlySeparately
15
Do you own your own home?* This field is required.
YESNO
16
Have you recently refinanced to take advantage of lower interest rates?* This field is required.
YESNO
17
What is the remaining balance on your primary residence? * This field is required.
18
Do you currently have children under 18?* This field is required.
No
Yes - 1
Yes - 2
Yes - 3 or more
19
Would you like help creating a college savings plan for them?* This field is required.
YESNO
20
How comfortable are you with investing?* This field is required.
Very Comfortable
Somewhat Comfortable
Not Comfortable at all
21
If your investments dropped by 10% today, what would you do?* This field is required.
Invest more
Do nothing
Sell to cut losses
22
Do you have a 401(k)?* This field is required.
YESNO
23
Do you have an IRA?* This field is required.
YESNO
24
Do you have an emergency fund?* This field is required.
YESNO
25
Please estimate your current household income* This field is required.
Over $500,000
$250,000-$499,999
$150,000 - $249,999
$100,000 - $149,999
$75,000 - $99,000
Under $74,999
26
Please estimate your total investable assets* This field is required.
Over $20,000,000
Over $10,000,000
Over $5,000,000
Over $1,000,000
$500,000 - $999,999
Under $500,000
27
Please estimate the total assets you are looking to invest at FORM Wealth.* This field is required.
Over $20,000,000
Over $10,000,000
Over $5,000,000
Over $1,000,000
$500,000-$999,0000
Under $500,000
28
Please estimate your current monthly savings* This field is required.
Over $2,000
$1,000 - $1,999
$500 - $999
$250 - $499
Less than $250
29
How did you hear about FORM Wealth Advisors?* This field is required.
Recommendation from family or friend
Lake & Country
Google Search
Other
30
Whom can we thank for the recommendation to FORM Wealth Advisors?
31
Name* This field is required.
First Name
Last Name
32
Email* This field is required.
example@example.com
Confirm Email
33
Phone Number* This field is required.
Area Code
Phone Number
34
What is your preferred method of contact?* This field is required.
PhoneEmail
35
Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curacao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
36
Is there anything else you'd like us to know?
37
Thank you for taking the time to fill out this form!We will be in touch in the next 24-48 business hours to follow up with the next step in our process. For you own records, you will receive a copy of your answers via email.
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