Personal Finance Assessment Form

PERSONAL FINANCE ASSESSMENT FORM

THIS QUESTIONAIRE IS REQUIRED WHEN SCHEDULING YOUR COACHING SESSION. IT IS VERY IMPORTANT THAT YOU SHOW UP AT THE SCHEDULED TIME. IF YOU DON'T SHOW UP OR CONTACT US, YOU LOSE THE CHANCE TO RESCHEDULE.
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Country*
What is Your Age*
Marital Status*
Occupation*
What is Your Monthly Income?*
What is Your Total Household Income?*
What is Your Total Estimated Monthly Expenses?*
What is Your Estimated Net Worth?
What are Your Short-term Goals?*
What are Your Long-term Goals?
What is the Main Obstacle Keeping You From Reaching Your Financial Goals?*

Expenses meets or exceeds my incomeNeed information in financial money managementBudgetingLack of savingsExcessive spendingSetting goals and sticking to themLack of education or skills needed to advanceHave savings but fail to investNeed to learn investment strategies to grow my available cashLack of belief that financial wealth is obtainable for meLack of overall motivationPoor creditNo creditI loss my job and I'm back to square oneThere is no one in my circle of family or friends that encourages me financially.I need to understand how to figure net worthOther
In your own words, in addition to the above listed items, what can be do to help you with your personal finances.
Are you Knowledgable in the Following Investment Areas?*

HomeownershipReal Estate InvestingStocks and BondsCryptocurrencyInsurance Options (i.e. Aunnities)Banking Options (i.e. Money Market and CDs)Business OwnershipOther
What is Your Ideal of Financial Freedom/Wealth?*
On a Scale of 1-5 (5 being the highest) How Serious are you About Working on Changing Your Financial Status to Gain Financial Freedom?*
How did you find out about us?
Should be Empty:

PERSONAL FINANCE ASSESSMENT FORM