• Budget & Chill | Client Financial Assessment

  • Welcome to Budget & Chill!

    Your Money. Your Goals. Your Peace of Mind.

    Thank you for choosing Budget & Chill, a financial wellness service offered by Chill's Enterprises, LLC.

    This assessment helps us understand your current financial situation, spending habits, and financial goals so we can develop a personalized budget and practical financial strategy tailored to your needs.

    Please answer each question as accurately as possible. Estimates are welcome when exact amounts are unavailable.

    Your privacy matters. We will never ask for your banking login credentials, routing numbers, or full bank account numbers through this questionnaire.

    Before You Begin 

    Please have your income, monthly expenses, debt balances, and savings information available before starting. This assessment must be completed in one sitting, as your progress cannot be saved.

    Let's get started!

  • Format: (000) 000-0000.
  • How would you prefer to be contacted?*
  • Are you creating this budget for yourself or your household?*

  • Section 2: Income Information

    Please provide information about the income you use to support yourself or your household. Use your take-home income (after taxes and deductions), and include all applicable income sources. Estimates are acceptable.
  • What is your current employment status?*
  • What are your sources of income?*
  • How often do you receive your primary income?*
  • Do you have more than one source of income?*
  • Does anyone else contribute income toward the household expenses included in this budget?*

  • Section 3: Monthly Expenses

    Please provide your estimated monthly household expenses. Include all expenses that apply to the budget you are creating. If an expense varies from month to month, enter your best monthly estimate. If you pay an expense weekly, quarterly, or annually, please indicate that so we can calculate an accurate monthly amount.You do not need to provide banking information or upload bank statements to complete this assessment.
  • What is your current housing situation?*
  • Do you have any additional housing expenses? (Select all that apply. If none, select "None" only.)

  • Utilities & Household Bills

    Enter the amount you personally pay each month. If a bill varies, use your best monthly estimate. Enter 0 if the expense does not apply.

  • Transportation Expenses

    Please provide your average monthly transportation expenses. Include vehicle-related costs and any public transportation or rideshare expenses. Enter 0 if an expense does not apply.

  • Food & Household Essentials

    Please estimate how much you spend each month on food and everyday household necessities. Include only the amounts you personally pay or that are covered by the household budget you're creating. Enter 0 if an expense does not apply.

  • Childcare, Healthcare & Insurance

    Please provide your estimated monthly expenses for childcare, healthcare, and insurance. If you pay an expense annually or at another interval, convert it to a monthly estimate when possible. Enter 0 if an expense does not apply.

  • Lifestyle & Personal Spending

    Please estimate your average monthly spending on personal, recreational, and lifestyle expenses. Include recurring subscriptions and occasional purchases. If an expense does not apply, enter 0.

  • Debt & Financial Obligations

    This section helps us understand your current debts, monthly payment obligations, and repayment priorities. Please provide approximate balances, minimum monthly payments, and interest rates when available. Estimates are acceptable. Do not provide full account numbers or login credentials.
  • What types of debt do you currently have?*

  • Current Debt Details

    Please provide information about your outstanding debts. If you have no debt, you may leave this section blank.

  • Debt Reporting Instructions

    For each debt, include:

    • Creditor or lender name

    • Type of debt

    • Current balance

    • Minimum monthly payment

    • Interest rate (APR), if known

    Example: Capital One — Credit Card — $2,500 balance — $75 monthly minimum — 24.99% APR

    Auto Loan — $12,000 balance — $350 monthly payment — 6.5% APR

    List each debt on a separate line. Do not include account numbers.

  • Are you currently behind on any debt payments?*
  • What is your biggest debt repayment priority?*

  • Section 5: Savings & Financial Goals

    This section helps us understand your current savings habits, financial resources, and short- and long-term goals. Please provide estimates when exact amounts are unavailable. Your responses will help us create a realistic savings strategy that aligns with your priorities.
  • Do you currently have money set aside in savings?*
  • Do you currently have an emergency fund?*
  • What is your biggest challenge when it comes to saving money?*
  • What are your primary financial goals? (Select all that apply.)*
  • Which financial goal is your highest priority right now?*
  • When would you ideally like to make meaningful progress toward your top financial goal?*

  • Section 6: Financial Habits & Budgeting Challenges

    This section helps us better understand how you currently manage your money, the financial challenges you experience, and the areas where you would like additional guidance. Your responses will help us develop a realistic budgeting strategy that fits your lifestyle.
  • Do you currently follow a monthly budget?*
  • How do you currently track your spending?*
  • What are your biggest challenges when managing your finances? (Select all that apply.)*
  • How often do you struggle to pay your bills by their due dates?*
  • How confident do you feel about managing your finances?*

  • Section 7: Client Expectations & Next Steps

    This final section helps us understand your expectations for Budget & Chill, your preferred budgeting approach, and the level of financial guidance you are seeking. Your responses will help us tailor our recommendations and determine the next steps in developing your personalized financial plan.
  • What type of budgeting support are you most interested in?*
  • How would you prefer to receive and manage your personalized budget?*
  • What level of budgeting support would you prefer after receiving your personalized budget?*
  • How would you prefer to communicate with Budget & Chill regarding your financial assessment and personalized budget?*

  • Client Acknowledgment & Consent

  • I understand that the information I provide in this financial assessment will be used by Chill's Enterprises, LLC, through its Budget & Chill service, to evaluate my financial situation and develop personalized budgeting recommendations.

    I acknowledge that the information I provide is accurate and complete to the best of my knowledge. I understand that estimates are acceptable when exact figures are unavailable.

    I understand that completing this assessment does not guarantee specific financial outcomes, does not establish a client-service relationship by itself, and does not authorize Chill's Enterprises, LLC to access or manage my financial accounts.

    I understand that additional services, including ongoing budgeting support, may require a separate agreement and additional fees.

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