Assante Financial Management Ltd. - Stephen Jones

Prospective Client Questionnaire

Hello!

Thank you for taking the time to fill out our Prospective Client Questionnaire. This survey helps us determine your financial needs when it comes to comprehensive financial planning.

Our office specializes in reviewing our client's financial affairs on a holistic level, focusing on 6 major areas (Estate Planning, Tax Management, Risk Management, Investment Strategy, Retirement, and Cash Flow Planning). If this type of service fits your needs, we would be happy to meet with you!

The survey below has a total of 9 questions, and should take less than 10 minutes to fill out. Thanks!

By providing your email address, you provide us with your express consent to send you commercial electronic messages related to finances and/or investments that may be of interest to you. Should you wish to discontinue receiving emails of this nature, you may contact us to withdraw your consent at any time at elizabeth.jones@assante.com.
Your personal information will not be distributed, sold, or traded – it will remain strictly confidential and will only be used for the purpose for which it was provided. For more information on Assante’s commitment to privacy and responsible use of information, please visit www.assante.com/privacy-policy.

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* 1. Contact Information:

Name

Home Phone

Work Phone

Cell Phone

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* 2. How would you prefer we get back to you?

Home Phone

Work Phone

Cell Phone

No Preference

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* 3. Age:

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* 4. Have you ever worked with a Wealth Advisor? If yes, please describe your best and worst experiences:

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* 5. How important are the following services to you?

	Very Important	Moderately Important	Not Important
Estate Planning	Estate Planning Very Important	Estate Planning Moderately Important	Estate Planning Not Important
Tax Management	Tax Management Very Important	Tax Management Moderately Important	Tax Management Not Important
Risk Management	Risk Management Very Important	Risk Management Moderately Important	Risk Management Not Important
Investment Strategy	Investment Strategy Very Important	Investment Strategy Moderately Important	Investment Strategy Not Important
Cash Flow Planning	Cash Flow Planning Very Important	Cash Flow Planning Moderately Important	Cash Flow Planning Not Important

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* 6. What are your biggest financial concerns? What keeps you up at night?

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* 7. If we could solve one problem for you, what would that problem be?

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* 8. Investable Assets ($):

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* 9. What are you currently invested in:

Stocks and Bonds

Mutual Funds

Exchange Traded Funds (ETFs)

Guaranteed Investment Certificate (GICs)

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* 10. How did you first hear about our office?

Website

Facebook

Google

Other - Referral, etc. (please specify)