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* 1. Please enter your first name, last name and email address.

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* 2. Can you describe how your life would be if you had less financial stress?

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* 3. What two to three goals are you trying to achieve and how do you think coaching will help?

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* 4. What are the top two or three behaviors you could modify today that could change your financial outlook for the better?

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* 5. What would you like to be able to do with your money that you aren’t able to do now?

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* 6. What one financial accomplishment would you be most proud of if you were able to achieve it?

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* 7. On a scale of 1 to 10 (10 being extremely committed), how committed are you to modifying your current financial behaviors if the end result is positive?

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* 8. What types of debts do you have?

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* 9. If you share a home with your significant other, is this individual committed to engaging in the financial fitness coaching process?

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