CLIENT FINANCIAL SNAPSHOT

CLIENT FINANCIAL SNAPSHOT

Thank you for making Compass Financial Wellness part of your financial journey. I look forward to serving your needs!
Client Information

Please complete the following questionnaire to the best of your ability as I will use this information to prepare for your first coaching session.
Name

First NameLast Name
Age
Email
example@example.com
Cell Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Relationship Status
Spouse/Partner Name

First NameLast Name
Spouse/Partner Email
example@example.com
Spouse/Partner Phone Number

Area CodePhone Number
Do you have dependent children? (Do not include adult children living on their own.)

YesNo

What is your total household gross income?
Gross income includes your wages, dividends, capital gains, business income, retirement distributions as well as other income.
Do you have any additional monthly income sources besides your primary job?

YesNo
Do you regularly contribute to a retirement fund or investment accounts?
Do you regularly contribute to an Educational Savings Account (ESA) or 529 plan?
Do you have an emergency fund?
Do you have any non-mortgage debt?
If you have non-mortgage debt, how much is it?
Are you a cosigner on any loans?
Do you rent or own your residence?

RentOwn
Do you use credit cards?

Do you currently use a monthly budget?
Have you been through Financial Peace University?
Is it important for you to "Keep up with the Joneses"?
Do you compare yourself and your lifestyle to others on social media?
If married, do you use a joint checking and joint savings account?
If married, do you discuss major purchases?
Do you donate to charitable organizations?
List your financial goals:
List any questions that you would like to discuss:

Financial Coaching Agreement

To help guide our relationship, I ask that you review and agree to the information below.
SCHEDULING APPOINTMENTS

To schedule an appointment, please go to calendly.com/cfw-llc or call me at 315-949-2210. I understand that your time and resources are extremely valuable, so I ask that you honor your scheduled appointment time. If you need to reschedule, just let me know in advance. Appointments can be conducted in person, over the phone or via video conference.

SPOUSAL PARTICIPATION

If you are married, both spouses must participate and commit to all scheduled coaching sessions. If your spouse is not available for an appointment, we will reschedule.

REFUND POLICY

I do not offer refunds for our coaching services as they are a fee-for-time service. I promise that you will get out of the coaching session what you put into it.

COACHING SERVICES

I assume the responsibility of understanding and evaluating your current needs, goals, and resources in order to develop a stratgy to meet your objectives. However, in order to make your plan work, I expect that you will come prepared to take the steps necessary to succeed, take full responsibility for your plan and its implementation, and contact me when you need additional advice and direction.

PAPERWORK

You are asked to complete preliminary paperwork to better prepare me as your coach. I ask that these forms be filled out to the very best of your knowledge and ability prior to your scheduled appointment. You assume all responsibility for providing accurate and complete materials, documentation, and facts upon which our coaching may be based.

RESCHEDULING APPOINTMENTS

If you need to reschedule your session for any reason, please give me at least 24-hour advance notice.

CONFIDENTIALITY POLICY

I will keep completely confidential all matters discussed, facts revealed, and the nature and content of all documents you provide to me or I generate. I will reveal such matters only upon receipt of a written authorization and clear, verifiable instructions from you telling me exactly what we may reveal.

DISCLAIMER

Coaching is designed to give you accurate and authoritative information with regard to the subject matter covered. I am not authorized to render legal, accounting, or other professional services. Since your situation is fact-dependent, you must additionally seek the services of an appropriate licensed legal, accounting or investing service.

I agree with the terms of the Coaching Agreement.
Signature

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CLIENT FINANCIAL SNAPSHOT

Client Information

Financial Coaching Agreement