Intake form

Name *

Email address *

What is your current financial situation?

Please select at least one option.

In debt

Debt-free

Struggling to save

Able to save

What type of debt do you currently have?

Please select at least one option.

Credit card debt

Student loans

Mortgage

Personal loans

Business loans

What are your main financial goals?

Please select at least one option.

Pay off debt

Save for retirement

Build an emergency fund

Invest in stocks

Purchase a home

How did you hear about us?

Would you like to schedule a consultation?

What is your preferred method of communication?

Please select at least one option.

Email

Phone

Video call

In-person meeting

What is your current employment status?

What is your annual income range?

Additional questions or comments

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