Financial Life Checkup


The statements below will help you think about and assess how satisfied you are with many aspects of your financial life.

The following information is strictly
confidential and will not be disclosed
to anyone without your consent.
Personal Information
 (*=required field)
First Name: * 
Last Name: *
Address: *

City:

 *
State: *
  Zip Code: *
Home Phone: *
Work Phone: *
Email: *

Directions:  Please answer all questions by selecting the answer that best indicates your response.
 

 

 

1= Not satisfied
3= Moderately satisfied
5= Very satisfied

I am satisfied...

 1 2 3 4 5

1)   …with my ability to meet my financial obligations

2)   …with the income potential my current job or career provides me

3)   …with my spending habits

4)   …with the level of debt that I carry

5)   …with the “extras” that I am able to buy for myself and/or loved ones.

6)   …with the level and quality of insurance protection that I currently have.

7)   …with the amount of money that I save and invest on a regular basis.

8)   …with my current investment choices.

9)   …that I am on track to build a sufficient retirement nest egg.

10)   …with the level of employee benefits that I receive.

11)   …with my style of personal bookkeeping and financial records management.

12)   …with my plans for my children’s education.

13)   …with my estate plan.

14)   …with my level of charitable giving.

15)   …with the level of personal financial education that I have attained.

16)   …with how I respond emotionally to my personal issues.

17)   …with my ability to communicate about my financial matters.

18)   …with the feelings that I have about my money life.

19)   …that financial issues do not cause stress or strain in the relationships that are important to me.

20)   …with the working relationships that I have with my financial service providers (i.e., insurance agent, banker, financial planner, broker, and accountant).
     

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