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32
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1
When will you retire?
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1-4 years
5-9 years
10-19 years
20-29 years
30+ years
Already Retired
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2
Getting close! How confident are you in your current financial plan?
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Very confident
Somewhat confident
Not confident
I don't have a plan
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3
What activity is most important to you in retirement?
*
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Traveling
Spending time with family and friends
Pursuing hobbies
Working part-time
Other
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4
Which word most accurately describes your vision of retirement?
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Enjoyment
Freedom
Leisure
Other
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5
Where do you expect the majority of your retirement income to come from?
*
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Savings and investments
Employer (Pensions)
Government
Other
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6
Are you planning on relocating for retirement?
*
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Yes
No
Not sure
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7
How would you characterize your overall health?
*
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Excellent
Good
Fair
Poor
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8
How comfortable are you with investing?
*
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Very comfortable
Somewhat comfortable
Not comfortable at all
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9
How quickly would you like to improve your long-term financial strategy?
*
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As soon as possible
Within the next 3 months
Within the next year
No specific timeframe / I don't want to make any changes
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10
Are you married?
*
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No
Yes
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11
Are you saving jointly or separately?
*
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Separately
Jointly
Not Applicable
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12
Do you own your home?
*
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No
Yes
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13
Have you refinanced your home recently to take advantage of low interest rates?
*
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No
Yes
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14
Do you currently have children under 18?
*
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No
Yes, 1
Yes, 2
Yes, 3 or more
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15
Would you like help creating a college savings program for them?
*
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No
Yes
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16
Do you own a business?
*
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No
Yes
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17
Do you have a 401k?
*
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No
Yes
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18
Do you have an IRA?
*
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No
Yes
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19
Do you have an emergency fund?
*
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No
Yes
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20
Which of these is most important for your financial advisor to have?
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Tax expertise
Investment management expertise
Estate planning expertise
None of the above
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21
Is socially responsible investing important to you?
*
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Must have
Nice to have
Not important
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22
Do you currently have a financial advisor?
*
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Yes
No
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23
Why are you looking for a new one?
*
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I’m unsatisfied with my current advisor
I’d like to get another advisor’s perspective
I have substantial wealth that I’d like to divide with another advisor
I recently relocated
Other
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24
Do you need your financial advisor to be in your immediate area?
*
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I am comfortable working by phone or video
Yes
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25
Please estimate your household income.
*
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Less than $40,000
$40,000 - $74,999
$75,000 - $99,999
$100,000 - $149,999
$150,000 - $249,999
Over $250,000
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26
Please estimate your total investable assets.
*
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Less than $25,000
$25,000 - $99,999
$100,000 - $249,999
$250,000 - $999,999
$1,000,000 - $4,999,999
Over $5,000,000
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27
Please estimate your current monthly savings.
*
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Less than $100
$100 - $249
$250 - $499
$500 - $999
$1,000 - $1,999
Over $2,000
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28
How did you hear about us?
*
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Social media
Internet search
Online ad
TV
Physical mail
Referral
Other
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29
Where should we send your personalized retirement report?
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30
Email
*
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31
Almost Done! What's your name?
*
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First Name
Last Name
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32
Mobile phone number
*
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Important: you'll receive your report shortly after we verify your information
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