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Financial Planning Questionnaire

Estimated time required (2 minutes)


The following questionnaire has been created to help me to understand your financial needs and goals more clearly and to understand your feelings and understandings about all areas of financial planning.

The questionnaire also helps us to understand your present financial strategy, to establish if there are any weaknesses in it and to clearly see how I can best help you to resolve them.

Your participation in this questionnaire is completely voluntary.

Your questionnaire responses will be strictly confidential and data will be reported only in the aggregate. Your information will be coded and will remain confidential. If you have questions at any time about the questionnaire or the procedures, you may contact [Name of Survey Researcher] at [Phone Number] or by email at the email address specified below.

Thank you very much for your time and support. Please start with the survey now by clicking on the Continue button below.

 
 
 
 
* First Name : 
* Last Name : 
Address 1 : 
Address 2 : 
City : 
State : 
Zip : 
* Phone : 
* Email Address : 
 
 
 
What is your date of birth?
 
 
 
What is your marital status?
 
Single (Never married)
 
Married
 
Domestic partnership
 
Widowed
 
Divorced
 
Separated
 
Don’t know
 
 
 
Spouse/partner's name:
   
 
 
 
Date of birth?
 
 
 
How many children do you have?
 
no children
 
1 child
 
2 children
 
3 children
 
more than 4 children
 
 
 
Which company do you work for?
   
 
 
 
Job title:
   
 
 
 
How long have you been working for the company?
 
Less than a year
 
1-2 years
 
3-5 years
 
6-10 years
 
More than 10 years