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Pre-Meeting Questionnaire
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General Information
First Name
Last Name
Email
Age
Street Address
City
State
Zip code
Marital Status:
Married
Single
Divorced
Widowed
If married, spouse’s name
Do you have children?
Yes, and they are independent
Yes, and they are dependent
No
Do you or your spouse have children from a previous marriage?
Yes
No
Transitions
Have you recently transitioned or are still transitioning through any of the following (select all that apply)?
Retirement
Marriage
Career change or promotion
Loss of a parent or spouse
Divorce
Having Children
Goals
What are your primary financial and life goals (select all that apply)?
Determining an age to comfortably retire
Guidance in budgeting
Saving for retirement
Saving for a child’s college education
Planning my estate
Managing my investments
Understanding my taxes and how they can be reduced
Financial giving / Charity
Simplifying and organizing my financials
Other
If other, please explain:
Budgeting & Debt
Are you aware of the amount of money you spend on a monthly basis?
Yes
No
Do have any outstanding debts?
Yes
No
If yes, please select all of the following debts you have outstanding:
Mortgage
Auto Loan
Credit Card
Student Debt
Medical Debt
Other
If other, please explain:
Investments
Are you currently or have you ever worked with a financial advisor?
Yes
No
Which of the following are valuable qualities that you would like to see in your ideal advisor (select all that apply)?
Trust
Credentials
Willing to teach financial information to me
Willing to be collaborative
Takes ownership of my problems as if they were their own
Has wisdom, knowledge, and experience that allow for valuable financial recommendations
Cares about financial needs as well as emotional, relational, and spiritual ones
Values financial gifting / Charity
How much involvement would you like in the investment process?
I prefer to delegate those responsibilities to an advisor
I prefer to collaborate with an advisor
What is your attitude toward risk?
Risk averse
Risk neutral
Risk seeking
What is your investment objective?
Preserve capital
Generate income
Promote growth
The sum of your savings, investments and retirement accounts has a value of
$0 - $1,000,000
$1,000,000 - $2,500,000
$2,500,000 - $7,500,000
$7,500,000 - $12,500,000
$12,500,000 +
Which of the following investments do you currently own (select all that apply)?
Money market account
Mutual fund
Index funds
Individual stocks
CD’s
Previously purchased annuity (fixed or variable)
Exchange traded funds
Individual bonds
Employee Benefits and Perks
Which of the following employee benefits do you or your spouse receive (select all that apply)?
Deferred compensation plan
Employee stock ownership plan
Employee stock purchase plan
Pension plan
Stock options
Supplemental executive retirement plan
Retirement
Which of the following retirement accounts do you have (select all that apply)?
IRA
SEP
401K
457
Roth IRA
Simple IRA
403b
Annuity
Other
Have you begun receiving social security benefits?
Yes
No
Are you or have you ever been a government employee?
Yes
No
Real Estate
Do you own a home?
Yes
No
If yes, do you have a mortgage?
Yes
No
Do you own rental properties?
Yes
No
Taxes
Do you prepare your own taxes?
Yes
No
Are you self-employed?
Yes
No
Estate
Do you have a will?
Yes
No
Do you have a trust?
Yes
No
Contact Information
What is your preferred way for us to contact you?
Phone
Email
If phone –
If email –
How did you find out about our services?
Submit