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Get in touch (Office use only)

Get in touch - Fin365 Lead - Office Use Only

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Who have you been referred by (name)?

Relationship to you

If other, please provide details

Basic details

Client 1

Client 2

Client 1 First name

Client 2 First name

Client 1 Last name

Client 2 Last name

Client 1 Phone

Client 1 Email*

Client 2 Phone

Client 2 Email

Client 1 Age

Client 2 Age

Marital status

Country of residence

Australia

Overseas/other

If overseas/other, please confirm your location

Postcode

Do you have children?

Yes, I have adult children

Yes, I have young children

No

One on the way

You can choose more than one option.

Client 1 employment type

Retired

Self employed

Full time

Part time

Home maker

Other

You can choose more than one option.

Client 2 employment type

Retired

Self employed

Full time

Part time

Home maker

Other

You can choose more than one option.

Client 2 employment type

Retired

Self employed

Full time

Part time

Home maker

Other

You can choose more than one option.

If other, please provide details

If other, please provide details

Client 1 occupation

Client 2 occupation

I am interested in

Reviewing my superannuation

Planning for retirement

Dealing with an inheritance

Investing my money

Helping manage my investments

Making sure my wealth is structured well long term

Deal with life after divorce

Help with aged care for either myself or my parents

Business structures and tax

Reviewing my insurance

I'm just starting out and want to start investing

I think I just need help, not sure where to start

Getting help with my cashflow

It's complicated

Looking for a second opinion

You can choose more than one option.

Assets

Tell us a little about your home status

I own my own home and the mortgage is paid off

I own my own home with a large mortgage

I own my own home with a small mortgage

I don't own my own home

My/our superannuation is currently worth

Above $3,000,000

$2,000,000 - $3,000,000

$1,000,000 - $2,000,000

$500,000 - $1,000,000

$200,000 - $500,000

Less than $200,000

Not sure

Do you have any of the following investments outside of your home and superannuation?

Shares

Investment property/s

Cash or term deposits

Other

No, I don't have any

You can choose more than one option.

The value of my investments outside of home and superannuation is

Above $3,000,000

$2,000,000 - $3,000,000

$1,000,000 - $2,000,000

$500,000 - $1,000,000

$200,000 - $500,000

Less than $200,000

Not sure

Is there anything else you need us to know?

Professional advisers and first contact

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Who are you currently getting advice from? (OLD - CHECKBOXES)

Existing financial planner

Stockbroker

Accountant

None / not applicable

You can choose more than one option.

Who are you currently getting advice from?

If other, please provide details

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How did you hear about us? (OLD - RADIO BUTTONS)*

Heard us on 4BC radio

Newspaper article

Barron's list

Heard us on ABC radio

Google

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If other, please provide details (OLD - LINKED TO RADIO BUTTON VERSION

How did you hear about us?

If other, please provide details

Newsletter sign up

Yes, I'd like to receive your newsletter

Phone call notes

Name

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