Financial Fitness Health Assessment

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Please answer the questions truthfully and to the best of your ability in order to receive accurate Financial Fitness Assessment results.

Email *

My first name is *

My age is *

I am *

Single

Married

I have *

no kids

1 kid

2 kids

3 kids

4 kids

5 or more kids

What matters most to me right now is to *

stop living paycheck to paycheck

pay off debt

save for retirement

save for emergencies

changing or learning money habits

My yearly household income is *

Less than $20,000

$20,000 - $39,999

$40,000 - $59,999

$60,000 - $79,999

$80,000 - $99,999

$100,000 - $149,999

$150,000 - $199,999

Over $200,000

My savings account has a balance of *

$250 - $500

$1,000

Over $1,000

Can you pay $1,000 in cash for an emergency? *

Yes, I can take $1,000 from my savings account

I use my credit card for emergencies

I don't know

If I lost my income, my savings would last me *

I don't have a savings to live off of

1 month

2 months

3-6 months

My total debt (credit cards, auto loans, student loans, etc.), NOT including primary mortgage, is *

I am DEBT FREE!

Less than $5,000

Over $5,000 but less than $10,000

Over $10,000 but less than $20,000

Between $20,000 and $50,000

Between $50,000 and $100,000

Between $100,000 and $150,000

Between $150,000 and $200,000

Over $200,000

I have open credit card accounts *

2-5

6-10

11-20

Over 20

I do not own a credit card

I currently invest a percentage of my income *

I do not invest

1-3%

4-6%

7-10%

11-14%

15% or more

I currently save for kid's college *

I do not have extra money to save towards a college fund

I do save to a college fund

I do not have kids

My housing situation is *

I rent

I have a mortgage payment

My home is paid off

I live at home or for free

I am planning to buy a house in the next *

year

2 years

3-5 years

I don't know how I will afford to buy a house

I already have a house

When it comes to my financial fitness health and handling my money, I feel *

Anxious

Worried

Frustrated

Confused

Confident

My financial future looks *

amazing!

average

scary

unknown...I never think about my financial future

Because of my money situation, I feel like I will never have the things I want in life. *

Disagree

Agree

I can enjoy life because of the way I’m managing my money. *

Disagree

Agree

I am just getting by financially. *

Disagree

Agree

I am concerned that the money I have or will save won’t last. *

Disagree

Agree

Giving a gift for a wedding, birthday or other occasion would put a strain on my finances for the month. *

Disagree

Agree

I have money left over at the end of the month. *

Disagree

Agree

I am behind with my personal finances. *

Disagree

Agree

List your top three Financial Goals for 2022 *

List 3 concerns or questions related to your financial situation *

A copy of your responses will be emailed to the address you provided.

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