Full Name:
Email:
Age:
Male Female
Tel:
Yrs of Education:
(HiSchool=12, Bachelor's=16, Master's=18, Ph.D., Ed.D., M.D., J.D.= 20)
For the items below, answer on a 1-7 scale: 1 = extremely low, 2 = low, 3 = moderately low, 4 = moderate or average, 5= moderately high, 6 = high, 7 = extremely high.
A. How much financial worry or stress do you presently feel?
B. How much financial wealth have you presently attained?
C. How much financial wealth do you desire in the future?
D, Compared to how positive you have felt about money the past year, with "4" being average for you, today you feel how positive
For each item, check the response closest to your truth : a, b, or c
1. When it is necessary to do extra work to attain or sustain my idea of financial success, my attitude is closest to:
Regarding my overall long term financial goals, I have:
My first thoughts when I hear the words "financial change" are closest to:
My feelings toward my financial situation tend to be:
If I were to have a sizable financial loss, I probably would:
I find that imagining myself as a wealthy person is:
After I have had time to evaluate a stressful financial event, my reaction usually most resembles which of the following sayings:
Regarding my career goals, I have:
My financial goals for building my estate for my senior years generally have been:
When I'm working on an important financial goal and it seems necessary to take a series of small steps, my approach is closest to:
Right after I realized I made the costliest financial mistake of my life, I felt:
After my initial reaction to making a sizable financial mistake, my strongest feeling is:
In the past, carrying out my major financial and/or career goals has involved making:
After my initial reaction to an unpleasant financial event, I usually:
I tend to look upon financial changes in my life as:
If I were to borrow $50,000 today at current interest rates, the number of ways I can think of to invest it so that I'll net a profit?
When someone I’m in a financial relationship with (e.g. client, banker, colleague, boss, financial advisor) says or does something that really aggravates me, I respond most often by:
My financial plans for the next one to two years:
Since I graduated high school, my financial goals and the steps to achieve them have:
The amount of purpose and meaning I presently have with my work--or free time if not working-- is:
Becoming a homeless person is something I:
During the past year, the degree to which I have run my financial life consistent with the following the saying, "An ounce of prevention is worth a pound of cure," is:
My attitude toward making financial mistakes is closest to:
During the past year, the role that financial planning has played in my personal life has been:
During the past year, the overall feelings I have had toward making my life more financially successful could be summed up as:
Right now, the number of realistic ways I think of to earn money is:
Assume I have a solid relationship with my financial advisor, and I like an investment he or she thinks has a small risk of loss. Further assume I risk a small to moderate amount of my money in this investment and lose somewhat more than expected. I probably would:
Usually, my feelings toward taking small steps to attain my long term financial goals are:
During the low point of my life financially, I:
My overall financial plans are:
My ability to work on difficult, challenging financial tasks one step at a time is:
Regarding handling my financial affairs, my behavior is closest to:
Overall, the efforts I've been making with regard to saving for retirement have:
Of the people I know, how many might be truly helpful in my plans to improve my financial situation?
Taking a series of small steps to achieve financial goals is:
When something bad financially is happening in my life:
If I were to encounter an upsetting financial problem, I think I would:
When I think about how my financial position will be in my later years, I have:
After my initial reaction and analysis, I usually handle financial setbacks and disappointments by:
If I had to give up whatever my major occupation presently is (if any) and go to a city I had never been in before, how many types of work can I think of which I could handle and perhaps land a job?
Thus far, the last important financial change I initiated has turned out:
If I had a sizable setback financially, my response would tend to be:
Thus far in my life, my behavior with money has been:
My honest response to dealing with conflict in a financial relationship is:
