We are SO glad you're here! We've designed these questions for us to learn a little about you in preparation for our first meeting. The more we know about you, the better we can serve you!
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| What is your name?* | {"type":"text","name":"IncomeMonthlySalary","width":100,"value":"","size":"Normal","validation":"NE","validationMessage":"Please fill in this item.","placeholder":""}
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| What's your age? | {"type":"text","name":"IncomeMonthlyRentals","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
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| Type of Work: | {"type":"text","name":"IncomeMonthlyChildSupport","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
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Spouse Name:
Spouse Age:
Spouse Type of Work:
| {"type":"text","name":"IncomeMonthlyOther","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
{"type":"computed","name":"monthlyIncomeTotal","width":50,"value":"","size":"Large","validation":null,"validationMessage":null,"formula":"IncomeMonthlySalary +IncomeMonthlyRentals +IncomeMonthlyChildSupport +IncomeMonthlyOther ","hidden":false}
{"type":"computed","name":"monthlyIncomeTotal2","width":50,"value":"","size":"Large","validation":null,"validationMessage":null,"formula":"IncomeMonthlySalary +IncomeMonthlyRentals +IncomeMonthlyChildSupport +IncomeMonthlyOther ","hidden":false}
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| What financial course(s) have you been through? If any | {"type":"text","name":"ExpenseRent","width":100,"value":"","size":"Normal","validation":"NE","validationMessage":"Please fill in this item.","placeholder":""}
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What has your experience been working with a coach(es) up to this point? If applicable
| {"type":"textarea","name":"expenseInsurance","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","height":80,"placeholder":""}
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What is your annual salary?
Do you use a monthly budget?
How much is in your emergency fund? If you have one
Do you have retirement investments?
How much do you contribute to your retirement investments monthly?
What is the present Balance? | {"type":"text","name":"expenseMaintenance","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
{"type":"text","name":"__generic","width":50,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
{"type":"text","name":"__generic","width":50,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
{"type":"text","name":"__generic","width":50,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
{"type":"text","name":"__generic","width":50,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
{"type":"text","name":"__generic","width":50,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
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Debt
(this won't define your future!)
| Student Loans | {"type":"text","name":"expenseCell","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
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| Credit Cards | {"type":"text","name":"expenseInternet","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
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| Vehicle Loans | {"type":"text","name":"expenseElectric","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
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| Taxes | {"type":"text","name":"expenseGas","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
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| Other Loans | {"type":"text","name":"expenseWater","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
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| Are you behind on any loan payments | {"type":"text","name":"expenseUtilityOther","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
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| Total Debt | {"type":"computed","name":"expenseUtilitiesTotal","width":50,"value":"","size":"Normal","validation":null,"validationMessage":null,"formula":"expenseCell +expenseInternet +expenseElectric + expenseGas +expenseWater +expenseUtilityOther ","hidden":false}
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| What gives you a sense of purpose | {"type":"textarea","name":"expenseCarPayment","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","height":80,"placeholder":""}
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Do you feel like you are able to live out that purpose?
| {"type":"text","name":"expenseCarInsurance","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
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Are you willing to try a different approach to managing your finances to get you more desirable results?
| {"type":"text","name":"expenseCarGas","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
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| What is the primary issue you want help with? | {"type":"text","name":"expenseCarRepair","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
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What have you tried so far that isn't working for you?
How are you hoping our coaching can make a difference in this area?
| {"type":"textarea","name":"expenseTransportationTotal6","width":50,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","height":80,"placeholder":""}
{"type":"textarea","name":"expenseTransportationOther","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","height":80,"placeholder":""}
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| We understand that the discussion of financial matters may be sensitive, scary, and can often involve shame. We seek to be very respectful and provide the utmost dignity during our meetings. What would make you feel comfortable during our initial conversation? | {"type":"textarea","name":"expenseTransportationTotal7","width":50,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","height":80,"placeholder":""}
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Great job spending the time on this, client. It takes a lot to be vulnerable and share where you're at - you've come to the right place to reach your goals. Don't forget to mark this complete below!
