• Financial Planning & Wealth Strategy Intake

    A warm, clear intake form to help GHS Consulting qualify you for wealth strategy, life insurance, credit building, and partner-assisted credit repair.

  • Page 1 - Contact

  • Format: (000) 000-0000.
  • Preferred Contact Method*
  • Date of Birth*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Marital Status*

  • Page 2 - Goals

  • What are the three most important financial goals you want to accomplish?
  •
  • Desired services

  • Page 3 - Wealth Building

  • Current assets owned
  • Risk comfort*
  • Currently work with a CPA, accountant, attorney, or licensed financial professional

  • Page 4 - Life Insurance Prequalification

  • Preliminary prequalification only: final coverage availability and pricing are subject to carrier underwriting.
  • Which life insurance products are you interested in?*
  • Do you currently have life insurance?*
  • Have you used nicotine or tobacco in the past 12 months?*
  • Do you have any major ongoing medical conditions or prescription medications?*
  • Have you been hospitalized in the past 5 years?*

  • Page 5 - Credit

  • Credit building is provided in-house. For credit repair, GHS Consulting works with a trusted referral partner.
  • Get an updated three-bureau IdentityIQ report here: https://www.identityiq.com/sc-securemax.aspx?offercode=431284WJ
  • Primary credit goal*
  • Which of the following apply to your current credit situation?
  • Target timeline
  • Upload a File
    Drag and drop files here
    Choose a file
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  • Final Page - Acknowledgment and Consent

  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Disclaimer
  • Should be Empty: