You can always press Enter⏎ to continue
Welcome to Shep's "How Prepared am I?" Self Assessment
A confidential self-assessment tool. You will receive your results via email.
START
1
Welcome Message from Shep Harmon
This "How Prepared am I?" quiz is confidential and complimentary.
Previous
Next
Submit
Press
Enter
2
How confident are you about these statements?
Click or tap on the blue circle and slide it to the right or left.
I have discussed my wishes with my family regarding assisted living, nursing care and my Advance Directive.
I have made arrangements for my end-of-life wishes, including funeral plans, organ donation, and final messages to loved ones, and my family knows where to find these documents.
I have created a specific action plan to share my family legacy plan, my personal photos and videos, family memorabilia with my family.
Not Confident
Somewhat Confident
Confident
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Not Confident
Somewhat Confident
Confident
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Not Confident
Somewhat Confident
Confident
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
I have discussed my wishes with my family regarding assisted living, nursing care and my Advance Directive.
I have made arrangements for my end-of-life wishes, including funeral plans, organ donation, and final messages to loved ones, and my family knows where to find these documents.
I have created a specific action plan to share my family legacy plan, my personal photos and videos, family memorabilia with my family.
Not Confident
Somewhat Confident
Confident
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Not Confident
Somewhat Confident
Confident
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Not Confident
Somewhat Confident
Confident
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Previous
Next
Submit
Press
Enter
3
How confident are you about these statements?
Click or tap on the blue circle and slide it to the right or left.
I have created an emergency plan that includes important contacts and what to do in various emergency scenarios.
I have appointed one of my family members to be my Estate Executor/ Personal Representative and have discussed my estate with them at length.
I have informed my family where to find my important personal information, such as birth certificate, social security number, and passport.
Not Confident
Somewhat Confident
Confident
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Not Confident
Somewhat Confident
Confident
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Not Confident
Somewhat Confident
Confident
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
I have created an emergency plan that includes important contacts and what to do in various emergency scenarios.
I have appointed one of my family members to be my Estate Executor/ Personal Representative and have discussed my estate with them at length.
I have informed my family where to find my important personal information, such as birth certificate, social security number, and passport.
Not Confident
Somewhat Confident
Confident
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Not Confident
Somewhat Confident
Confident
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Not Confident
Somewhat Confident
Confident
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Previous
Next
Submit
Press
Enter
4
How confident are you about these statements?
Click or tap on the blue circle and slide it to the right or left.
My family members are aware of my primary doctor's contact details and my medical history, including allergies and medications.
I have documented all my insurance policies (health, life, vehicle, property) and their details, and my family knows where to find them.
I have met with my estate planner within the last two years.
Not Confident
Somewhat Confident
Confident
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Not Confident
Somewhat Confident
Confident
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Not Confident
Somewhat Confident
Confident
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
My family members are aware of my primary doctor's contact details and my medical history, including allergies and medications.
I have documented all my insurance policies (health, life, vehicle, property) and their details, and my family knows where to find them.
I have met with my estate planner within the last two years.
Not Confident
Somewhat Confident
Confident
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Not Confident
Somewhat Confident
Confident
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Not Confident
Somewhat Confident
Confident
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Previous
Next
Submit
Press
Enter
5
How confident are you about these statements?
Click or tap on the blue circle and slide it to the right or left.
There is a record of all household expenses and management details that my family can easily access.
I have documented all relevant information about my vehicles, including insurance, maintenance history, and loan details.
My spouse or future executor knows where to find usernames and passwords for my online accounts, including email and social media.
Not Confident
Somewhat Confident
Confident
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Not Confident
Somewhat Confident
Confident
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Not Confident
Somewhat Confident
Confident
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
There is a record of all household expenses and management details that my family can easily access.
I have documented all relevant information about my vehicles, including insurance, maintenance history, and loan details.
My spouse or future executor knows where to find usernames and passwords for my online accounts, including email and social media.
Not Confident
Somewhat Confident
Confident
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Not Confident
Somewhat Confident
Confident
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Not Confident
Somewhat Confident
Confident
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Previous
Next
Submit
Press
Enter
6
How confident are you about these statements?
Click or tap on the blue circle and slide it to the right or left.
There is a comprehensive list of my properties and assets, including real estate, personal property, and investments, that my family can access.
Documenting my personal possessions for my next of kin will require significant effort.
I am very comfortable with technology like computers, phones, online accounts and storing files.
Not Confident
Somewhat Confident
Confident
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Not Confident
Somewhat Confident
Confident
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Not Confident
Somewhat Confident
Confident
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
There is a comprehensive list of my properties and assets, including real estate, personal property, and investments, that my family can access.
Documenting my personal possessions for my next of kin will require significant effort.
I am very comfortable with technology like computers, phones, online accounts and storing files.
Not Confident
Somewhat Confident
Confident
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Not Confident
Somewhat Confident
Confident
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Not Confident
Somewhat Confident
Confident
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Previous
Next
Submit
Press
Enter
7
Please describe what keeps you up at night regarding passing away or becoming incapacitated:
This response is optional.
0/50
Previous
Next
Submit
Press
Enter
8
Please provide the Email where you want to receive your results
*
This field is required.
We protect your privacy and do not sell nor share your details.
example@example.com
Previous
Next
Submit
Press
Enter
9
Would you like to give your name?
Confidential; your name is never shared nor sold.
Previous
Next
Submit
Press
Enter
10
Would you like a call from Shep Harmon?
15 minutes at no cost.
Please enter a valid phone number.
Previous
Next
Submit
Press
Enter
Should be Empty:
Question Label
1
of
10
See All
Go Back
Submit