At [Company Name], we are committed to supporting your overall well-being, including financial health. As part of our Corporate Wellness Program, we are offering a Debt Management Education series to help you gain control over your finances, reduce stress, and achieve long-term financial stability. Please take a few minutes to complete this form to help us tailor the program to your needs and preferences.
Date
Employee Name
Department
How would you rate your current level of financial stress?
Very High
High
Moderate
Low
Very Low
Do you currently have any form of debt?
Yes
No
Prefer not to say
What types of debt do you currently have? (Check all that apply)
Card Debt
Student Loans
Mortgage
Car Loan
Personal Loan
Medical Debt
Other (Please specify):
How confident are you in managing your debt?
Very Confident
Somewhat Confident
Neutral
Not Very Confident
Not Confident at All
Please indicate your level of interest in the following topics. We will use this information to prioritize the content of our workshops and resources.
Topic | Rating (1=Very Interesting, 5=Very Uninteresting) | ||
|---|---|---|---|
A | B | ||
1 | Understanding Different Types of Debt | ||
2 | Creating a Personal Budget | ||
3 | Strategies for Paying Off Debt | ||
4 | Credit Score Improvement | ||
5 | Debt Consolidation Options | ||
6 | Managing Student Loan Debt | ||
7 | Avoiding Common Debt Traps | ||
8 | Negotiating with Creditors | ||
9 | Financial Planning for the Future | ||
10 | Understanding Interest Rates and Fees | ||
11 | Bankruptcy: What You Need to Know | ||
12 | Emotional and Psychological Aspects of Debt | ||
13 | Tools and Apps for Debt Management |
What format do you prefer for the Debt Management Education sessions?
In-Person Workshops
Virtual Webinars
One-on-One Financial Coaching
Self-Paced Online Courses
Printed Materials/Guides
Other (Please specify):
How often would you like to attend these sessions?
Weekly
Bi-Weekly
Monthly
Quarterly
Other (Please specify):
What time of day works best for you to attend these sessions?
Early Morning (Before Work)
Lunchtime
After Work Hours
Weekends
Other (Please specify):
How long should each session be?
30 Minutes
1 Hour
1.5 Hours
2 Hours
Other (Please specify):
What specific financial challenges are you currently facing that you would like help with?
Do you have any suggestions for topics or resources that you would find helpful?
Is there anything else you would like to share about your financial wellness needs?
I understand that my responses will be kept confidential and will only be used to tailor the Debt Management Education program to better meet my needs.
I am interested in participating in the Debt Management Education program.
Employee Signature
Thank you for your feedback!
Your input is invaluable in helping us create a program that supports your financial well-being. If you have any questions or need further assistance, please contact [Wellness Program Coordinator Name] at [Email Address] or [Phone Number].
Form Template Insight
Please remove this form template insight section before publishing.
The Debt Management Education for Corporate Wellness Programs Form is a structured tool designed to gather employee feedback and preferences regarding financial wellness initiatives, specifically focusing on debt management. Below is a detailed breakdown of each section, its purpose, and how it contributes to the overall effectiveness of the program.
1. General Information
This section collects baseline information about the employee's financial situation and stress levels. It helps the organization understand the prevalence of debt-related issues and the level of financial confidence among employees.
2. Preferred Topics for Debt Management Education
This section is the core of the form, as it identifies the specific topics employees are most interested in learning about. By ranking their interest levels, the organization can prioritize the most relevant and impactful content.
3. Preferred Format and Schedule
This section ensures that the program is accessible and convenient for employees, increasing participation and engagement.
4. Additional Feedback
This open-ended section provides employees with an opportunity to share specific challenges, suggestions, or concerns that may not be covered in the structured questions.
Specific Financial Challenges:
5. Consent and Confidentiality
This section ensures transparency and builds trust between the organization and employees.
Interest in Participation:
Key Benefits of the Form
How to Use the Data Collected
Analyze Interest Levels:
Conclusion
This form is a powerful tool for designing a Debt Management Education program that is both employee-focused and data-driven. By understanding employees' financial challenges, preferences, and needs, organizations can create a program that not only reduces financial stress but also fosters long-term financial wellness. This, in turn, contributes to improved productivity, morale, and overall corporate well-being.
To configure an element, select it on the form.