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First Name

Last Name

Phone

Your profession or occupation

What’s your income range?

Do you earn income outside of Canada?

Yes No

What’s the main reason you want to speak with a financial advisor?

What are your top 2 financial goals?

What are your top 2 financial challenges?

What have you tried so far to overcome those challenges?

What did you learn about money growing up?

If your income were to stop tomorrow, what would your safety net be?

My Emergency Fund (Chequing, savings account) Selling Some Investments (RRSP, TFSA, Non-Registered, Real Estate etc.) Asking Friends and Family for Help I have passive income that will tide me over I don’t have a safety net built up yet

How long would your safety net last before you’d need to go into debt?

If you saw your investment portfolio falling sharply, what would you do?

Sell and run for cover Hold on for dear life Buy more, but let’s do it slowly Buy Buy Buy! Here’s all my money Where can I get more money to invest?

If you receive a sizable bonus today, how would you use this money?

Put it straight into my retirement, I am not touching it Book my next vacation and check another destination off my bucket list Perfect, I need to pay down my debt This goes straight to building up my emergency fund Invest the money for a major purchase within the next 3 years

Do you have a corporation?

Yes No

Do you have anyone who depends on you financially? If so, who?

What charitable causes most resonate with you and why?

What’s your preferred method of contact? (check all that apply) *

Call Email Text

If applicable, please include the full name of the person who referred you to complete this form.

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The Right Advisor Can Change Your Entire Future.

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(It takes just a few minutes)

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