Financial Clarity Journey™ Pre-Meeting Assessment
Pre-meeting assessment for Legacy Serenity Solutions. Please answer as completely as you can; all fields default to optional unless otherwise indicated.
Basic Information
Full Name
First Name
Middle Name
Last Name
Preferred Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
example@example.com
City / Province
Occupation
Employer / Industry
Relationship Status
Please Select
Single
In a relationship
Married/Common-law
Separated/Divorced
Widowed
Prefer not to say
Children / Dependents
Yes
No
If yes, how many?
What Brought You Here
What prompted you to book a Financial Clarity Review?
What are your biggest financial goals right now?
Getting out of debt
Building an emergency fund
Saving for a home
Planning for retirement
Improving cash flow/budgeting
Saving for children’s education
Investing/growing wealth
Other
What financial concerns or stresses are currently on your mind?
What would “financial freedom” look like for you personally?
Income & Cash Flow
Approximate Annual Household Income
Under $50,000
$50,000–$74,999
$75,000–$99,999
$100,000–$149,999
$150,000–$199,999
$200,000+
Is your income from any of the following?
Salary/Wages
Self-employed/Business income
Commission-based
Seasonal/Variable
Pension/Retirement income
Government benefits
Other
Do you currently follow a monthly budget?
Yes, consistently
Somewhat/loosely
No
How would you describe your current financial organization?
Very organized
Somewhat organized
Not very organized
Credit & Debt Profile
Approximate Credit Score
Below 600
600–659
660–719
720–799
800+
Not sure
Have you experienced any of the following?
Late or missed payments
Collections
Bankruptcy/Consumer proposal
High credit utilization
None of the above
Current Debts
Credit cards
Personal loans/Lines of credit
Student loans
Car loan/Lease
Payday loans
Tax debt
Other
Approximate Total Monthly Debt Payments
Real Estate & Home Equity
Do you currently own real estate?
Yes
No
Property Type
Primary residence
Secondary/Vacation home
Rental/Investment property
Other
Approximate Current Home Value
Under $250,000
$250,000–$399,999
$400,000–$599,999
$600,000–$799,999
$800,000+
Not sure
Approximate Remaining Mortgage Balance
Current Access to Home Equity Options
HELOC
Refinancing options
Other home equity products
Not sure
Is your home equity currently helping support your financial goals?
Yes
Somewhat
No
Not sure
Have you ever explored using home equity strategically?
Yes
No
I’d like to learn more
Savings & Assets
Do you currently have any of the following?
Emergency savings
TFSA
RRSP/RSP
RESP
Non-registered investments
Employer pension/Group plan
Other
Approximate Total Savings/Investments
Under $5,000
$5,000–$24,999
$25,000–$74,999
$75,000–$149,999
$150,000–$299,999
$300,000+
Not sure
Protection & Insurance
Do you currently have any of the following protection or insurance coverage?
Life insurance
Disability insurance
Critical illness insurance
Mortgage insurance
Group benefits through employer
Not sure
Other
Do you feel financially protected if something unexpected happened tomorrow?
Yes
Somewhat
No
Not sure
Your Priorities
What would you most like help with?
Getting clear on my overall financial picture
Reducing or restructuring debt
Improving cash flow and budgeting
Using home equity more strategically
Building savings and investments
Retirement planning
Protecting my family or insurance planning
Other
Is there anything specific you would like reviewed during our meeting?
Meeting Preferences
Preferred Meeting Type
In-person
Virtual (Zoom/online)
Phone
Preferred Meeting Times
Weekday mornings
Weekday afternoons
Weekday evenings
Saturdays
Flexible/open to options
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