Name:  

Phone: 

E-mail: 

         Value                                                             Satisfaction Level                                                                     Rank
                                                                                1   2    3   4   5    6   7   8   9   10
Life Direction                                                                                                          

                                                                                1   2    3   4   5    6   7   8   9   10
Cash Flow                                                                                                               

                                                                                1   2    3   4   5    6   7   8   9   10
Income/Career/Lifestyle                                                                                          

                                                                                1   2    3   4   5    6   7   8   9   10
Retirement Plan                                                                                                      

                                                                                1   2    3   4   5    6   7   8   9   10
Other Savings Goals                                                                                               

                                                                                1   2    3   4   5    6   7   8   9   10
Risk Management (Insurance)                                                                                 

                                                                                1   2    3   4   5    6   7   8   9   10
Estate Planning                                                                                                        |

                                                                                1   2    3   4   5    6   7   8   9   10
Charitable Giving/Involvement                                                                                |

                                                                                1   2    3   4   5    6   7   8   9   10
Investments                                                                                                             |

                                                                                1   2    3   4   5    6   7   8   9   10
Decision Making                                                                                                      |

                                                                                1   2    3   4   5    6   7   8   9   10
Monitoring Progress Toward Goals                                                                         |

Goals & Dreams

1.  What is important about money to you?

 

2.  What money messages did you get growing up?

 

3.  If you were to suddenly receive a lot of money, what would you
change in your life?

4.  If you learned that you had only five years to live, but you would
be healthy during that time, what would you change in your life?

 

5.  If you learned that you had only one more day to live, what would
be your biggest regret?

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