Free Virtual 1-on-1 Financial Planning Consultation - Interest Form for Colorado Disaster Survivors

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

United Policyholders is hosting a pro bono, virtual/online financial planning clinic for wildfire survivors on Wednesday, January 26th from 1pm-4pm. By completing the form below, you can request a 45-minute appointment, free of charge, with a volunteer financial planner. We have a limited number of appointments available. If you are selected for the clinic, we will notify you by email and confirm your availability. If a spot is not available for you, we will hold your request form for the next one.

Your name *

Email *

Phone number *

Was your home damaged or destroyed by the recent 2020 wildfires? *

Damaged (partial/standing/smoke loss)

Destroyed (total loss)

Neither

Please let us know the county of your damaged or destroyed home. *

Please tell us more about your situation *

I have questions about rebuilding

I have questions about my mortgage

I am underinsured

I am retired

I am considering buying elsewhere

I am considering different types of loans

I have or anticipate receiving settlement funds from a lawsuit

Other:

Required

Please provide more information on the situation or questions you would like to discuss with a financial planner.

Do you have access to a computer, an internet connection, and the ability to use the Zoom application?

Yes

Clear selection

If you would like to invite your disaster case manager to attend your appointment, please provide that person's email address:

If you are not matched with a time slot or are unavailable for this clinic, would you like to be added to the waitlist for a future clinic?

Yes

Clear selection

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of United Policyholders. Report Abuse

Forms