Client Name(s)* TelephoneEmail Address* To help us clearly understand your current situation, please complete the Personal Blueprint. Rate your reactions to each pair of phrases by deciding where you belong on a sliding scale. Your responses will be submitted to an advisor who will contact you to help you realize your goals. I have not set any clear goals for my financial future.I have set some clear goals for my financial future. I do not have a written strategic financial plan in place. I have a strategic financial plan in place. I am not confident that I will have sufficient funds at retirement.I am confident that I will have sufficient funds at retirement. In the event of a medical condition, I do not have the financial resources readily available to seek out the best treatment in the world.In the event of a medical condition, I have the financial resources readily available to seek out the best treatment in the world. I am not confident that if I became disabled for a period of time, my coverage is adequate and our lifestyle would not suffer greatly.I am confident that if I became disabled for a period of time, my coverage is adequate and our lifestyle would not suffer greatly. I am not confident that I have prepared well for my child’s education plans.I am confident that I have prepared well for my child’s education plans. I do not budget my cash flow well and find it difficult month to month.I budget my cash flow well and do not find it difficult month to month. I am not confident that my assets will be passed in the most effective way possible to my heirs.I am confident that my assets will be passed in the most effective way possible to my heirs. I am not happy with the financial advice I have received from my other advisor.I am happy with the financial advice I have received from my other advisor.
