Client Intake

CLIENT INTAKE FORM
OAKRIDGE FINANCIAL PLANNING LLC

Please complete this form as accurately and thoroughly as possible. The information provided will help us understand your financial situation and create a personalized financial plan. For supporting documents, please email them to zachary@oakridgefinancialplanning.com

NOTE: a "Save Progress" button is at the bottom of the form if you need to stop and come back later to finish filling out the information.
Basic Information
Full Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Address*
Phone Number - Text Eligible*
Format: (000) 000-0000.
Email*

Confirmation Emailexample@example.com
Marital Status*
Would you like to include your Spouse/Partner to the intake form?
Oakridge Financial Planning will assume adding them to the client intake form means they should be treated as part of the service agreement.
Dependents Names and Ages*
Employment Information
Occupation*
Employer*
Average Hours Worked per Week
Type of Pay*
Annual Base Income*
Total Other Annual Income*
Basic Information

Client #2 - If applicable
Full Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Address
Phone Number
Format: (000) 000-0000.
Email

Confirmation Emailexample@example.com
Marital Status
Dependents Names and Ages
Employment Information

Client #2 - If applicable
Occupation
Employer
Average Hours Worked per Week
Type of Pay
Annual Base Income
Total Other Annual Income
Referred By
YesNo
Please enter their Client ID, full name and email, or phone number.
Monthly Expenses

Average of Past 3 Months
Answer Format

Expense Name: Monthly Amount

Example

401(k): 500 or Groceries: 600
Savings & Investing / Month

Brokerage, 401(k), IRA, Emergency, Vacations, etc.
Debt Payments / Month

Mortgage/Rent, Student Loans, Car Payments, Credit Cards, etc.
Living Expenses / Month

Subscription, Groceries, Utilities, Clothing, Eating Out, etc.
Insurance Payments / Month

Healthcare, Homeowner, Life Insurance, Car Insurance, etc.
Taxes / Month

Federal, State, City, County, Property, Social Security, Medicare, etc
Assets
Answer Format

Account Name or Asset Type: Current Balance

Example

Bank of America Checking: 5000
Cash & Cash Equivalents

Checking, Savings, Cash, CDs, Precious Metals, etc
Investable Assets

Brokerage, IRA, 401(k), Crypto, Investment Homes, etc
Personal Use Assets

Furniture, Personal Belongings, Primary/Vacation Home, Art, etc
Securities Held

Stocks, ETFs, Crypto, Bonds, Etc
Format Example: AAPL - Charles Schwab Brokerage: 1000
Liabilities
Answer Format

Account Name or Type: Current Balance

Example

Chase Credit Card: 5000
Current Liabilities

Total Amount due in the next 12 months
Long-term Liabilities

Total Amount Owed minus Current Amount (entered above)
Estate Planning Information
YesNo
YesNo
Insurance Information
MedicalDentalVisionAutoMotorcycle/ATVRVHomeowners/RentersLife InsuranceUmbrellaOther
YesNo
Term LifeWhole LifeUniversal LifeOther
Total Life Insurance Benefit Amount:
Life Insurance Yearly Premium:
Client #2
MedicalDentalVisionAutoMotorcycle/ATVRVHomeowners/RentersLife InsuranceUmbrellaOther
YesNo
Term LifeWhole LifeUniversal LifeOther
Total Life Insurance Benefit Amount:
Life Insurance Yearly Premium:
Additional Notes & Special Considerations
Please provide any other information that may be relevant to your financial plan, needs, or wants.
Supporting Documents

Bank statements, Investment Account Statements, Will/Trust Docs, Loan Contract Terms, etc
Please provide at least two paystubs, last three bank statements, retirement plan documents, loan details/statements, credit card statements, etc.*

Cancelof
Consent and Signature
I confirm that the information provided is accurate and complete to the best of my knowledge. I understand that this information will be used to develop a financial plan tailored to my needs.
I authorize Oakridge Financial Planning LLC to obtain account statements from third-party institutions to assist in gathering necessary documents for my financial plan.
I confirm that the information provided is accurate and complete to the best of my knowledge. I understand that this information will be used to develop a financial plan tailored to my needs.
I authorize Oakridge Financial Planning LLC to obtain account statements from third-party institutions to assist in gathering necessary documents for my financial plan.
Date Signed*

MonthDayYear
Date
Client's Printed Name or Prepared By:*
I confirm my typed name is equivalent to my written signature and has the same binding force as my written signature.
Client #2 - Date Signed

MonthDayYear
Date
Client 2 Printed Name or Prepared By:
I confirm my typed name is equivalent to my written signature and has the same binding force as my written signature.
Should be Empty:

CLIENT INTAKE FORM

Basic Information

Employment Information

Basic Information

Employment Information

Referred By

Monthly Expenses

Savings & Investing / Month

Debt Payments / Month

Living Expenses / Month

Insurance Payments / Month

Taxes / Month

Assets

Cash & Cash Equivalents

Investable Assets

Personal Use Assets

Securities Held

Liabilities

Current Liabilities

Long-term Liabilities

Estate Planning Information

Insurance Information

Additional Notes & Special Considerations

Supporting Documents

Consent and Signature