Identify Your Financial Well-Being

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Question 1 of 10

Full Name & Occupation

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Question 2 of 10

Phone Number/ Email Address/ Date of Birth

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Question 3 of 10

Are you comfortable with the amount of money you’ve saved so far? If no, why not?

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Question 4 of 10

If you want to be financially secure in the future, what (3) steps can you start to take immediately?

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Question 5 of 10

What is your biggest fear about retirement?

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Question 6 of 10

If the Financial Advisor can provide you with solutions for your financial challenges, how much could you comfortably set aside monthly?

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Question 7 of 10

Do you have adequate long-term disability insurance coverage (equivalent to at least 60% of your salary)?

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Question 8 of 10

Have you established an emergency fund of equal to approximately three months’ salary?

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Question 9 of 10

Do you have a current Will and/or Living Trust?

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Question 10 of 10

On a scale from 1 - 5 how important is the transfer of “Generational Wealth” to you? (1=lowest, 5=highest)

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