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ZeroDebtCoach Intake Assessment

Before we jump on our discovery call, please take 2 minutes and tell me a little bit about your situation and what kind of help you're looking for.

Thanks for reaching out and I look forward to connecting with you! - Brad

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Start

Question 1 of 10

1. Briefly explain:

 

What is your purpose in reaching out to us? 

 

What kind of help are you looking for or goals you're trying to accomplish?

 

Please be as specific as possible.

Question 2 of 10

2. What is your (annual and/or monthly) household income before taxes? After taxes (if you know)?

Question 3 of 10

3. What is your age, relationship status and how many people in your family (including children)?

Question 4 of 10

4. What's your total non-mortgage debt?

Question 5 of 10

5. Do you have an emergency fund?

 

If so, how much do you have set aside for that?

Question 6 of 10

6. Are you budgeting regularly (at least monthly)?

A

Yes.

B

No.

C

In the process of learning.

Question 7 of 10

7. Are you currently investing? If so, what percentage of your income are you contributing?

Question 8 of 10

8. Have you ever invested in financial coaching or personal finance related courses (like FPU)?

A

No.

B

I've invested in financial coaching only.

C

I've invested in personal finance courses only.

D

I've invested in both.

Question 9 of 10

9. Do you agree to be on time for our call?*

 

Do you agree to complete any requests for follow up items within 24 hours?

 

*Please note that we do not reschedule "no shows" or "ghosting" so please communicate ahead of time if you need to reschedule. 

A

Yes.

B

No.

Question 10 of 10

10. On a scale from 1-3, how motivated are you to take dramatic action to improve your current situation?

A

3 - I'm extremely motivated to take dramatic action.

B

2 - I'm moderately motivated to take dramatic action.

C

1 - I'm pretty content with my current situation.

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