New Client Application Survey
Please spend 10 -15 minutes on this confidential questionnaire. Your responses help me understand how I can help you & your family with your money. I'll use this information to determine if it makes sense for us to schedule an introductory Zoom call. I have a 1-2 month waitlist for new clients, so if for any reason it does not make sense for us to schedule a call, I will work to provide you recommendations of financial planners I know and trust who are available sooner. Thank you for taking the time to fill this out. It's a big step to take!
Old - Name
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First Name
Last Name
First Name
*
Please use your full legal name
Last Name
*
Email Address
*
Phone Number
*
Format: (000) 000-0000.
Marital Status
*
Please Select
Single
Married
Long-Term Partnership
Divorced
Widowed
If you select "Married" or "Long Term Partnership," you will enter your partner's information on the next page.
Your Date of Birth
*
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Month
-
Day
Year
Home Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Do you have children? If so, what age(s) are they?
*
In what state do you live?
*
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
This is your primary residence, where you file taxes.
Old - Date of Birth
*
Old - 2nd Partner Name (if in a partnership/marriage)
First Name
Last Name
Old - State of Residence
*
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About your Spouse/Partner
Spouse's First Name
*
Please use their full legal name
Spouse's Last Name
*
Spouse's Email Address
*
Spouse's Date of Birth
*
-
Month
-
Day
Year
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Describe your current financial situation. Include an overview of income, debt, and savings.
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It's three years from today and we're chatting over coffee. You're telling me that you're really happy with the financial progress you've made over the past three years. What's happened to make you so happy?
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How did you hear about Deliberate Finances? If a specific person, please let me know who!
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Ongoing financial planning has a minimum annual fee of $6,000/year, rising with income, complexity, and net worth. Please check the box to confirm you have read and understand the minimum fee.
*
I have read & understand
Deliberate Finances has limited capacity to welcome new clients, and may only have a few openings over the next year. We may ask to put you on a waitlist if you would like to work together, or, we are happy to provide referrals to other financial advisors. What would your preference be?*
*
I have a strong preference for working with you, even if it means waiting up to 6 months.
I'd like to start working with an advisor as soon as possible, including someone you refer me to. You have my permission to share this survey with other advisors
Other (Add details in next field)
Anything else you want to share?
Submit
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