Financial Planning Intake · StressLess About Finance

Step 1 of 5

About You

Basic information so we can personalize your financial picture.

First Name *

Please enter your first name.

Last Name

Age *

Please enter your age.

City / State

Marital Status *

Single Married Partnered Divorced

Please select your marital status.

Number of Dependents

Ages of Dependents

Employment Status *

Employed (W-2) Self-Employed Both Other

Please select your employment status.

Phone Number

Preferred Contact Method

Email Phone Text

Step 2 of 5

Income & Expenses

Estimates are acceptable — we will refine these figures together on the call.

Income

Compensation Type *

Salaried Hourly

Please select your compensation type.

Net Take-Home Per Paycheck *

$

Please enter your take-home pay.

Side / Freelance Income (Monthly Avg.)

$

Employer 401(k) Match Receiving the full match?

%

Yes No No match offered

Fixed Monthly Expenses

Rent / Mortgage

$

Car Payment

$

Health Insurance

$

Auto / Other Insurance

$

Subscriptions (streaming, gym, etc.)

$

Loan / Debt Minimum Payments

$

Variable Monthly Expenses

Utilities (electric, gas, internet)

$

Groceries

$

Dining & Takeout

$

Transportation (gas, transit, rideshare)

$

Personal & Discretionary

$

Do you currently track your spending?

Yes, detailed Roughly Not really

Step 3 of 5

Savings & Debt

Your current financial position. This is the foundation of your plan.

Cash & Investment Accounts

Checking Account Balance

$

Savings / Emergency Fund

$

401(k) Balance

$

401(k) YTD Contributions

$

Roth / Traditional IRA Balance

$

IRA YTD Contributions

$

HSA Balance

$

Taxable Brokerage Balance

$

Debt

Do you currently carry high-interest debt (credit cards, personal loans above ~7%)?

Yes No / Paid Off

List each debt obligation

Step 4 of 5

Goals & Timeline

What you are working toward — in the near term and the long term.

What are your top financial priorities right now? * (Select all that apply)

Build / complete emergency fund Pay off debt Invest more / optimize retirement accounts Save for a home Increase income / develop additional revenue streams Establish a structured budget Plan for a major life event

Please select at least one priority.

Anticipated major expenses or life events in the next 1–3 years? (Select all that apply)

Target retirement age

Target annual retirement income

$

Have you previously worked with a financial advisor?

Yes No

Are you enrolled in an HSA-eligible health plan?

Yes No Unsure

Step 5 of 5

Almost There

A few final details to ensure we are fully prepared for your session.

What would you like to accomplish in our session?

What financial concerns are weighing on you most right now?

Is there anything unique about your financial situation we should be aware of?

Email Address *

Please enter a valid email address.

How did you hear about us?

✦

You're all set.

We will review your intake prior to your session and arrive fully prepared with your numbers.
Please check your email for a confirmation.