Money Coaching Assessment (for individuals + couples)

In order to hit the ground running + make the best use of our time together, I ask you to complete this assessment. Your answers help me to understand your money history, emotions you have around money, and to see what emotional - mindset blocks may be sabotaging you from meeting your money-life goals.

If you are part of a couple, I ask that you each complete separately.

Your thoughtful reflection is appreciated and I thank you in advance for the time + energy you put into this assessment.

Money Assessment

Name *

First

Last *

Last

Email *

What are your current frustrations and concerns about your finances today? What isn’t working for you? If you are part of a couple, what do you argue most about?

This process will be an investment of your time, energy and money. What specific goals do you want to accomplish in our work together to make this “worth it” for you?

What processes or practices, if any, do you engage in to make money work in your life? Examples are things such as, regular (weekly) dates with you and money, setting money-life goals and measuring your outcomes, creating a monthly cash flow plan and tracking your progress against the plan, monitoring + documenting your investments monthly…knowing the trends, journaling about your money beliefs, things of this nature.

Pretend you have a magic wand and in one big swoosh you could change your money-life picture to whatever you wanted it to be…describe what you would create.

How does money flow in your lives? List out and describe the purpose of each of your regular bank checking and bank savings accounts.

Share with me your money life goals and tell me about the behaviors you have in place that support you meeting those goals. Tell me as well about your goals and behaviors that don’t match up.

Financially speaking, what are you most proud of?

What is your biggest irritant or resentment when it comes to money?

What patterns or conflicts have you observed happening in your life with money? How have these patterns affected your wellbeing?

Imagine you + money sitting in a room together in comfy chairs. Money begins a conversation with you, telling you what it has been like to be in relationship with you…what would money tell you?

Money Beliefs / History

In this section, ASK your GUT to “fill in the blank.” Don’t use your head. Your money beliefs rule the way you think about money, the practices you bring to money and the emotions you have about money. Beliefs have emotional roots, that is why we want your GUT to respond here…and often what your gut has to say isn’t always rationale…and that is OK.

My biggest financial fear is:

I would describe my relationship with money as:

I’d love to have more money, but:

Me + money are like:

I feel money shame around:

One reason I would want to create more money in my life is:

The biggest money lesson I learned from my dad was:

The biggest money lesson I learned from my mom was:

My family (growing up) spent the most money on:

For me, being rich means:

Cash Flow

Please complete these “True” and “False” Statements together, if you are a couple. This section gives us a picture of behaviors you practice when it comes to your money.

Mail is opened daily and sorted

True

False

Bills are paid on time, late payments are rare

True

False

Some bills are not paid on time and become debts

True

False

I am aware of the relationship between my monthly expenses and monthly income

True

False

I make sure that my inflow of money is greater than my outflow of money each month

True

False

I know how much money I bring in monthly from my work or other sources

True

False

I create a monthly cash flow plan and track against it

True

False

I analyze my spending patterns and know my spending triggers

True

False

There is room for improvement in how I plan, track and analyze monthly cash flow

True

False

I am good at financing my needs before my wants

True

False

I plan my month to make sure that throughout the month, money flows easily and I do not suffer cash flow constrictions

True

False

My dollars nourish and fund my deepest values

True

False

Savings

Saving money is a habit for me

True

False

I have investment accounts such as IRA’s, 401K’s, 403B, etc

True

False

I have an account just for periodic expenses, a “save to spend” account for things like car repairs, summer camps, holidays, insurances, taxes

True

False

I have an emergency fund of 6 months of income easily available in a bank savings account, money market or certificate of deposit

True

False

I track my investment portfolio monthly, aware of the ups and downs

True

False

I understand the difference between saving and investing

True

False

If I don’t have the money for a purchase, I save for it rather than place that expense on a credit card

True

False

I have obstacles that keep me from saving money

True

False

Earnings

I earn to my full potential and receive market value for my services

True

False

I earn enough to live within my means, save for retirement and have money left over to have fun

True

False

I love the work I do

True

False

I receive raises on an annual basis

True

False

Bonus money can be counted on annually

True

False

Earning money is something I do very well

True

False

Annual raises get gobbled up in expanding lifestyle choices

True

False

Insurances

I have adequate auto coverage

True

False

I have $___________ term life insurance coverage

True

False

Short and Long term disability is in place through employers / individually funded

True

False

I have adequate health insurance

True

False

I have umbrella insurance

True

False

I have renter’s / home owners / flood / earthquake insurance

True

False

I have long term care insurance

True

False

I have professional liability insurance

True

False

I review all my insurance policies annually, to make sure I get the best rates and coverage that is best for my particular situation

True

False

I can locate all of my insurance policies

True

False

Names of beneficiaries are up to date on policies

True

False

I have a written / photographic / video-taped record of household goods

True

False

Estate Planning

I have a living will and trust

True

False

I have durable power of attorney for health care and finance

True

False

I have communicated with loved ones where important paperwork is in case anything happens to me

True

False

My living trust documents are current and up to date

True

False

Taxes

I have a tax accountant

True

False

I am current with federal and state taxes

True

False

I am free of liens on my property

True

False

I usually receive a yearly tax refund

True

False

I have a tax repayment plan in place with the IRS / State

True

False

I pay quarterly taxes on time and in full (business owner)

True

False

I can easily locate copies of the last 3 years income tax returns

True

False

Credit / Debt

My credit score is:

I have a relationship with credit where I go into revolving credit card debt, get out and repeat the cycle many times

True

False

I check credit card statements against purchase receipts

True

False

I pay off my credit card charges the same month the charges are incurred

True

False

I check my credit report about every 3-6 months to make sure statements are accurate

True

False

I have lists of my credit card numbers and whom to contact in case they are stolen

True

False

I know the exact amount of debt I owe

True

False

I know the annual amount of interest I pay on each debt

True

False

I want to eliminate my debt

True

False

My debt limits my life choices

True

False

The major reason I use credit cards is to accumulate air miles

True

False

I use my credit cards to supplement my earnings, because my earnings don’t cover my regular monthly expenses

True

False

I have a past history of bankruptcy

True

False

I realize using credit cards gives me the illusion I have more to spend than I actually do

True

False

Goals / Dreams / Communication

I know my financial net worth.

True

False

My financial net worth is:

I create yearly goals and figure out how to finance those goals without going into unsecured debt or eating away investments

True

False

I have weekly money meetings to discuss cash flow and other family money matters needing attention

True

False

I take responsibility for the behaviors (thinking, emotions, actions) I practice that creates my current money picture

True

False

I enjoy the details of managing my cash flow

True

False

I do what I want in my life regardless if I can afford it or not

True

False

I am good at knowing what my dreams are and trying to achieve them in a balanced way

True

False

What are your top three values in order of priority?

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