Financial Wellness Survey

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Thanks for your interest in our Financial Management Coaching, please complete the survey info below.

Name *

Email *

Phone Number *

Can you receive text reminders? *

Yes

必填

Marital Status *

Single

Married

Engaged

Widowed

Separated

Divorced

Are you currently in debt? *

Yes

What is your largest debt? *

Car

Credit Card

Student Loans

Medical

Home

其他:

Do you have consolidated student loans? *

Yes

Are your student loans or debt over 50K?

Yes

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Do you have a written or electronic budget? *

Yes (Written)

Yes (Electronic)

Have you recently suffered job loss? *

Yes

Have you filed bankruptcy or used a consumer credit agency to consolidate debt? *

Yes (Bankruptcy)

Yes (Consolidated Debt)

Are you interested in getting Financial Management Coaching? *

Yes

Already in coaching with Smart Jewelz Consulting

必填

Now that you've taken the first step a representative will reach out to help you start your financial freedom journey!!

💎 Jewelz of Inspiration💎

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