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Personal Finance Questionnaire

The aim of this form is to collect data on your current personal finance data. This helps to curate the coaching sessions specifically for your needs. Answer the questions below as accurately as possible.

First Name

Last Name

Email

Phone Number

Profession

Employed Self Employed Unemployed Other

If other, state the profession

How would you describe your knowledge about personal finances?

Fundamental/Basic Intermediate Advanced Expert

Have you set any financial goals?

Yes No Other

If other, please explain

What are those financial goals?

What are the timelines of your goals?

What is your monthly income?

Do you have any other income inflows?

How much do you make from your other income inflows?

What are your monthly expenses inclusive of entertainment and leisure?

Do you have currently have debt?

Yes No

How much debt do you have?

Do you feel like you are competently servicing your debt?

Yes No

Explain your answer above?

Do you have any savings? If yes, how much and where? If no, why?

What is the biggest challenge in your personal finances as at now?

Which among the following is your biggest concern related to personal finances?

Paying for school Loans Not being able to get rid of existing debts I cant afford health insurance Loosing my job None - I don't have financial worries Other

If other please explain

How important is it for you to have emergency funds?

Extremely important Somewhat important Not so important Not at all important I am not sure

I feel in control of my current financial situation (Rate the following on a scale of 1 - 5 (1= not at all true and 5=very true)

1 2 3 4 5

I feel capable of using my current income to achieve my financial goals. (Rate the following on a scale of 1 - 5 (1= not at all true and 5=very true)

1 2 3 4 5

I have an emergency savings fund established to cover 3 to 6 months of expenses should I lose the ability to work. (Rate the following on a scale of 1 - 5 (1= not at all true and 5=very true)

1 2 3 4 5

My finances are a significant source of worry for me. (Rate the following on a scale of 1 - 5 (1= not at all true and 5=very true)

1 2 3 4 5

What do you expect to gain or to learn from this coaching relationship?

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