Complimentary Consultation - Heiser Coaching

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Duration: 1 hour
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Financial coaching could be the most powerful thing you've done for yourself in a long while. I'm looking forward to giving you results in our time together. The purpose of this worksheet is to give me some context for YOU and what you're dealing with so our time is the most effective it can be. 

INCOME

What is your monthly net take-home pay?
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Do you have an irregular income?  

{"type":"radio","name":"__generic","width":15,"value":"","size":"Normal","validation":"C1","validationMessage":"Please make a selection for this item.","options":"Yes\nNo"}


Do you use a monthly budget?  

{"type":"radio","name":"__generic2","width":15,"value":"","size":"Normal","validation":"C1","validationMessage":"Please make a selection for this item.","options":"Yes\nNo"}


SAVINGS

Do you have an emergency fund? 
{"type":"radio","name":"__generic3","width":15,"value":"","size":"Normal","validation":"C1","validationMessage":"Please make a selection for this item.","options":"Yes\nNo"}



How much is in the fund?
{"type":"text","name":"income2","width":55,"value":"","size":"Normal","validation":"TI","validationMessage":"Please fill in this item.","placeholder":"Emergency fund: rounded to nearest $"}



Are you currently investing for retirement?
{"type":"radio","name":"__generic4","width":15,"value":"","size":"Normal","validation":"C1","validationMessage":"Please make a selection for this item.","options":"Yes\nNo"}



What is your current retirement fund balance?
{"type":"text","name":"income3","width":55,"value":"","size":"Normal","validation":"TI","validationMessage":"Please fill in this item.","placeholder":"Retirement fund: rounded to nearest $"}



What is your monthly retirement contribution?
{"type":"text","name":"__generic5","width":55,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":"Monthly contribute: rounded to nearest $"}



Do you contribute to non-retirement savings?
{"type":"radio","name":"__generic6","width":15,"value":"","size":"Normal","validation":"C1","validationMessage":"Please make a selection for this item.","options":"Yes\nNo"}



What is your current non-retirement fund balance?
{"type":"text","name":"__generic7","width":55,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":"Non-retire savings: rounded to nearest $"}



What is your monthly non-retirement contribution?
{"type":"text","name":"__generic8","width":55,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":"Monthly contribute: rounded to nearest $"}




HOUSING

Do you own or rent?
{"type":"radio","name":"__generic9","width":15,"value":"","size":"Normal","validation":"C1","validationMessage":"Please make a selection for this item.","options":"Own\nRent"}



Are you current on your payment?
{"type":"radio","name":"__generic10","width":15,"value":"","size":"Normal","validation":"C1","validationMessage":"Please make a selection for this item.","options":"Yes\nNo"}



What are the total monthly payment?
{"type":"text","name":"income4","width":55,"value":"","size":"Normal","validation":"TI","validationMessage":"Please fill in this item.","placeholder":"Housing payment: rounded to nearest $"}



What is current balance on your mortgage (if applicable)?
{"type":"text","name":"__generic11","width":55,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":"Mortgage balance: rounded to nearest $"}




CONSUMER DEBT

Do you have any vehicle loans?
{"type":"radio","name":"__generic12","width":15,"value":"","size":"Normal","validation":"C1","validationMessage":"Please make a selection for this item.","options":"Yes\nNo"}



What are your total monthly car payments? 
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List any total balances due:

Credit cards:    {"type":"text","name":"__generic14","width":55,"value":"","size":"Small","validation":"","validationMessage":"Please fill in this item.","placeholder":"Credit cards: rounded to nearest $"}


Student loans: {"type":"text","name":"__generic15","width":55,"value":"","size":"Small","validation":"","validationMessage":"Please fill in this item.","placeholder":"Student loans: rounded to nearest $"}


Taxes:               {"type":"text","name":"__generic16","width":55,"value":"","size":"Small","validation":"","validationMessage":"Please fill in this item.","placeholder":"Taxes: rounded to nearest $"}


Other:               {"type":"text","name":"__generic17","width":20,"value":"","size":"Small","validation":"","validationMessage":"Please fill in this item.","placeholder":"description"}

       {"type":"text","name":"__generic18","width":30,"value":"","size":"Small","validation":"","validationMessage":"Please fill in this item.","placeholder":"rounded to nearest $"}



WHAT PRIMARY ISSUE SHOULD WE FOCUS ON DURING YOUR CONSULTATION?

{"type":"radio","name":"__generic19","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please make a selection for this item.","options":"Budgeting\nReal Estate\nDealing with Collectors\nWealth Building / Investing\nDebt Elimination\nOther"}



What are you struggling with? 
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What have you tried so far?
{"type":"textarea","name":"__generic21","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","height":80,"placeholder":""}



And finally... what made you decide to take this step forward today?
{"type":"textarea","name":"__generic22","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","height":80,"placeholder":""}



Thanks for taking the time to prepare for our consultation.
I'm looking forward to serving you soon!