Section 1: About You
This section helps us understand a little more about you and your family. These details make sure any advice we provide is tailored to your situation.
Please complete the information below for each person. If you’re unsure about something, just leave it blank, that’s absolutely fine.
Client 1
Client 2
First Name 1
First Name 2
Last Name 1
Last Name 2
Date of Birth 1
Date of Birth 2
Phone Number 1
Phone Number 2
Email Address 1
Email Address 2
Postal Address 1
Postal Address 2
Occupation 1
Occupation 2
Marital Status
Dependents 1
Dependents 2
Section 2: Healthy, Wealthy, Happy
This section is about how you feel in three important areas of life: your health, your finances, and your happiness. There are no right or wrong answers. It’s simply a way for us to begin to understand what matters most to you.
Please rate each area on a scale of 1 to 10 , where:1 = I don’t feel satisfied at all;
Client 1
Client 2
Your Health
Physical health – having good health and enough energy to get things done on a daily basis. Exercising regularly, maintaining a balanced and healthy diet and getting enough sleep will encourage you to have a thriving physical wellbeing.
Healthy (Physical health) 1
Healthy (Physical health) 2
Your Wealth
Financial wellbeing means feeling confident and in control of your financial life. It’s not about having the most money or being an expert, it’s about knowing your needs are met and making informed choices for the future. Managing income, expenses, assets and liabilities effectively can give you peace of mind and the freedom to focus on what truly matters.
Wealthy (Financial) 1
Wealthy (Financial) 2
Your Happiness
Good emotional health does more than help you bounce back from illness, change, or misfortune, it supports resilience, clear thinking, and stronger relationships. When you feel emotionally well, you’re better equipped to handle stress, make confident decisions, and enjoy life’s moments. Emotional wellbeing is a foundation for overall happiness and financial confidence. It’s not just about coping it’s about thriving.
Happy (Emotional, career, personal growth, social connections) 1
Happy (Emotional, career, personal growth, social connections) 2
Section 3: Your Financial Position
This section gives us a snapshot of where you are financially now. It’s not about being perfect, it’s simply about understanding your current position so we can provide the best advice for you, your family and your goals.
Please complete the below as best you can. If you’re unsure about something, just leave it blank or make your best estimate.
Client 1
Client 2
Total Gross Annual Income
Total Gross Annual Income 1
Total Gross Annual Income 2
Total Annual Expenses
Total Annual Expenses 1
Total Annual Expenses 2
Surplus Monthly Cash
Surplus Monthly Cash 1
Surplus Monthly Cash 2
Assets
Value ($)
Liabilities
Amount Owing ($)
Residential Home
Residential Home
Home Mortgage
Home Mortgage
Home contents
Home contents
Vehicle Lease/Loan/s
Vehicle Lease/Loan
Vehicle/s
Vehicles
Credit card/s
Credit cards
Savings Account/s
Savings Accounts
Investment Loan/s
Investment Loans
Investment Property/ies
Investment Properties
Other
Other
Shares/Managed Funds
Shares/Managed Funds
Superannuation Funds
Superannuation Funds
Other
Other
Section 4: Your Personal Insurance
This section helps us understand what cover you already have in place. There are no right or wrong answers – it’s simply about getting a clear picture.
For each type of insurance, please select Yes , No , or Unsure . If you know the amount of cover, please include it.
We are uncertain that our current level of protection will provide our family with peace of mind in the event of ill health or injury.
Client 1
Select Yes, No or Unsure
Amount of Cover (if known)
TPD Insurance
TPD Insurance 1
Life Insurance
Life Insurance 1
Trauma Insurance
Trauma Insurance 1
Income Protection
Income Protection 1
Client 2
Select Yes, No or Unsure
Amount of Cover (if known)
TPD Insurance
TPD Insurance 2
Life Insurance
Life Insurance 2
Trauma Insurance
Trauma Insurance 2
Income Protection
Income Protection 2
Section 5: Financial Clarity & Control
This section is about understanding how you feel about your finances.
Please tell us about how you are feeling about each of these areas of your financial life.
Take a moment to highlight which areas are your top priority right now.
Current position
Priority
1. How organised do you feel when it comes to your money and bills?
Current position
Very organised
Somewhat organised
Not organised
Priority
Urgent
Important but not urgent
Not a priority right now
2. How confident are you that you know how much you will need for a comfortable, stress-free retirement?
Current position
Feel very confident
Feel somewhat confident
Do not feel confident
Priority
Urgent
Important but not urgent
Not a priority right now
3. How confident are you that you are taking advantage to legally minimise your taxes?
Current position
Feel very confident
Feel somewhat confident
Do not feel confident
Priority
Urgent
Important but not urgent
Not a priority right now
4. How confident are you that your family would have enough money in the event of your death or disability?
Current position
Feel very confident
Feel somewhat confident
Do not feel confident
Priority
Urgent
Important but not urgent
Not a priority right now
5. How confident are you that you know what would happen to your money and belongings if you passed away?
Current position
Feel very confident
Feel somewhat confident
Do not feel confident
Priority
Urgent
Important but not urgent
Not a priority right now
6. How certain are you that your loans are organised to save you money and reduce “bad debt”? (like high-interest credit cards or loans that don’t help you build wealth)?
Current position
Feel very confident
Feel somewhat confident
Do not feel confident
Priority
Urgent
Important but not urgent
Not a priority right now
Section 6: Are there any specific goals or issues you would like to address initially?
Other goals
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