Welch Financial Coaching
Financial Overview
Name
First Name
Last Name
Spouse Name
First Name
Last Name
Email
example@example.com
Spouse Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Cell Number
-
Area Code
Phone Number
Age
Spouse Age
Type Of Work
Spouse Occupation
Preferred Method of Contact
What primary issue should we focus on during your coaching session?
Budgeting
Real Estate
Dealing With Collectors
Wealth Building/Investing
Debt Elimination
Other
List the top three concerns/questions related to your above selection:
Income
What is your family's monthly take home pay?
*
Do you have an irregular income?
Yes
No
Do you have an emergency fund
Yes
No
I you have an emergency fund, how much is in it?
Emergency Fund Amount
Do you do a monthly budget?
Yes
No
Are you currently investing for retirement?
Yes
No
What is your balance?
What is your monthly contribution?
Do you contribute to non-retirement savings?
Yes
No
What is your balance?
What is your monthly contribution?
Do you have any other debt? (Taxes, Family etc.)
Yes
No
Balance on other debt?
Submit
Back
Next
Back
Next
Housing
Do you rent or own your home?
Rent
Own
Are you current with your payment and taxes?
Yes
No
Consumer Debt
Do you have any vehicle loans?
Yes
No
Are you current on your vehicle loans?
Yes
No
N/A
What are your total vehicle monthly payments?
How many credit cards do you have?
What is your total credit card balance?
Do you have any student loans?
Student loan balance
Should be Empty: