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Fa De Kulcha Intake Form

Welcome to your Financial Coaching Intake Form!

This form helps me understand your financial habits, challenges, and goals so I can create a personalized plan tailored specifically to you. Whether you're just starting your savings journey or looking to build confidence with investing, your information will help us make the most of our time together.

Please answer each question honestly — there are no wrong answers. Your responses are 100% confidential and only used to support your financial growth.

When you're ready, let's begin building your path to financial freedom.

Section 1: Client Information

Preferred Contact Method
Email
Phone
WhatsApp
Age Range

Section 2: Financial Snapshot

What are your current sources of income?
Approximate monthly take-home income:
Approximate monthly expenses:
Do you currently have any debt?
No
Yes - Under $5,000
$5,000-$15,000
$15,000+

Section 3: Goals & Priorities

How urgent are these goals?
Very urgent
Somewhat urgent
Not urgent

Section 4: Habits & Experience

How would you describe your current financial habits?
Very organised
Mostly organised
Somewhat organised
Not Organised
I'm starting from scratch
How comfortable are you with budgeting?
Very confident
Somewhat confident
Not confident
I've never budgeted before
How comfortable are you with investing?
Very confident
Somewhat confident
Not confident
I've never invested before

Section 5: Service interest & Final Notes

Which package are you most interested in?
Financial Foundations Consultation
Savings Kickstart (Starter Package)
Save & Invest Starter (Growth Package)
Financial Freedom Blueprint (Premium Package)
Not sure yet — please recommend the best fit
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