To what extent do you agree or disagree with the following statement about your financial picture and mindset?
My financial decisions support the life I want to live and the person I want to be.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
I understand the beliefs, emotions, and biases that influence my financial decisions.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
I have a clear view of my complete financial picture – all of my assets (what I own) and my liabilities (what I owe)
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
Money is a cause of stress, anxiety, or worry in my life.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
To what extent do you agree or disagree with the following statement about your goals and values?
I have specific financial goals and clear strategies to achieve them.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
I review my financial goals regularly and track my progress towards them.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
What was your Household Income last year?
Less than $40,000
$40,000 - $74,999
$75,000 - $99,999
$100,000 - $149,999
$150,000 - $249,999
Over $250,000
How much of your after-tax income are you able to save each month?
20%+
16%-20%
11%-15%
6%-10%
0%-5%
I don’t know
To what extent do you agree or disagree with the following statement about your cash flow and resource allocation?
I track my cash flow each month and know how much I spend, save, and invest.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
To what extent do you agree or disagree with the following statement about your taxes?
I am taking advantage of all available strategies to reduce the taxes I pay.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
I review my taxes and proactively plan for upcoming personal, professional, and financial changes.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
To what extent do you agree or disagree with the following statement about your borrowing and debt?
How much of your monthly income goes toward debt payments? (mortgage, car loan, student loans, etc.)
<10%
11%-20%
21%-30%
31%-40%
>40%
I don’t know
My debt and monthly payments are a cause of stress in my life.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
How much of your after-tax monthly income are you investing?
>15%
11-15%
6-10%
1-5%
0%
I don’t know
To what extent do you agree or disagree with the following statement about your investing?
I have a clear picture of all investments and the level of risk I am taking.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
How many months of expense could your Emergency Fund cover?
7+ months
5-6 months
3-4 months
1-2 months
0. I don’t have an emergency fund
To what extent do you agree or disagree with the following statement about your risk and insurance?
I have insurance coverage in all of the categories that are important to my financial well-being (e.g. health, disability, life, and property (e.g. home, car).
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
I review my insurance policies regularly and after major life changes to ensure they are up to date.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
When were your estate planning documents executed (e.g. your will, financial power of attorney, advanced healthcare directive)?
Within the last 3 years
Between 3-5 years ago
Greater than 5 years ago
N/A / I don’t have any
To what extent do you agree or disagree with the following statement about your estate planning?
I review my estate planning documents regularly to ensure they are up to date.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
To what extent is Education Planning a concern of yours?
Not a concern/interest and unlikely to be in the future
Likely to be a concern/interest at some point in the future
Education Planning is a current concern/interest
As a percentage of your income, how much are you saving towards an education?
5%+
4-5%
3-4%
1-2%
I am not currently saving
To what extent do you agree or disagree with the following statement about your education planning?
I am saving enough and using all tax savings opportunities available.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
As a percentage of your income, how much are you saving for retirement?
>21%
16-20%
11-15%
6-10%
<5%, but not zero
0%
I don’t know
How much have you already saved towards retirement?
$0 to $24,999
$25,000 to $99,999
$100,000 to $249,999
$250,000 to $999,999
$1,000,000 and up
To what extent do you agree or disagree with the following statement about your retirement planning?
I know how much money I need to save in order to achieve a financially secure retirement.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
To what extent do you agree or disagree with the following statement about your plan implementation?
I have the expertise and time to effectively implement all aspects of my financial plan.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
To what extent do you agree or disagree with the following statement about your plan implementation?
I periodically review my financial plan to evolve my strategies when there are changes in my life.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree