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BFM Initial Consultation Form
Thank you for your Interest in meeting! Please take a moment to fill out the form below prior to your scheduled meeting.
This information will help us begin to understand your financial picture and better assist you.
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Email
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Your email
Your Name:
*
Your answer
Phone Number
Your answer
Email Address:
*
Your answer
Spouse's Name:
Your answer
Spouse's Phone Number:
Your answer
Spouse's Email Address:
Your answer
Mailing Address:
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Spouse's Date of Birth:
MM
/
DD
/
YYYY
Are you and/or your Spouse Retired? Date of Retirement?
Your answer
If Working: What is your Occupation? Your Spouse?
Your answer
If Working: Your Planned Retirement Date?
MM
/
DD
/
YYYY
What is the the reason for your Inquiry?
Your answer
Do you have any specific questions or concerns for me?
Your answer
Do you currently have an Advisor (Name)?
Your answer
Do you have an Accountant (Name)?
Your answer
Do you currently have an Attorney (Name)?
Your answer
Do you currently have an Insurance Agent (Name)?
Your answer
What is your estimated annual income?
Your answer
What is your Spouse's estimated annual income?
Your answer
Sources:
Employment (W-2 / Salary)
Self-Employment/ Independent Contractor (1099)
Social Security
Pension
Rental Income
Other
What is your range of total investable assets?
$0 - $100,000
$100,000 - $250,000
$250,000 - $500,000
$500,000 - $1,000,000
$1,000,000 - $2,500,000
$2,500,000 or more
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How much do you have allocated to your emergency fund?
Your answer
What is your monthly mortgage/rent payment? If mortgage, please provide your current mortgage balance, mortgage origination date, interest rate, monthly payment, property taxes/insurance amounts, and type of loan (ie: 30-year fixed)
Your answer
What are you monthly MINIMUM debt payments? (Auto loans, credit cards, student loans, etc.?)
Your answer
What is a good estimate for your monthly expenses? (Not including minimum debt payments or mortgage/rent?)
Your answer
What is the balance of all of your debts?
Your answer
How much do you put into your Savings each month? (Retirement, home/property purchase, college, life insurance, etc.?
Your answer
What is the balance of all of your assets? (House, Savings, Retirement, etc.)
Your answer
What else should I know about you, your goals, family, etc.?
Your answer
How did you hear about us? ...
Friend
Linkedin
CFP Board
Podcast
Yelp!
Google
Mail
NAPFA
XY Planning Network
Referral from another Professional
Other
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