Financial Planning Assistance for Corporate Wellness Programs - Internal Employee Client Intake Form

Employee Information

First Name

Last Name

Employee ID

Department

Job Title

Start Date

Phone Number

Email Address

I. Financial Wellness Goals

Please indicate your primary financial goals (check all that apply):

Budgeting and expense management

Debt reduction and management

Saving for emergencies

Retirement planning

Investment education and planning

Tax planning and optimization

Homeownership planning (e.g., saving for a down payment)

Education funding (e.g., for self or dependents)

Estate planning (e.g., wills, trusts)

Other (please specify):

II. Preferred Financial Assistance Programs

Please select the types of financial assistance programs you are interested in:

 

Financial Education Workshops

Budgeting Basics

Debt Management Strategies

Retirement Planning 101

Investing for Beginners

Tax Planning Tips

Homeownership Preparation

Estate Planning Essentials

Other (please specify):

One-on-One Financial Coaching

Personalized budgeting assistance

Debt reduction plan creation

Retirement savings strategy

Investment portfolio review

Tax optimization consultation

Other (please specify):

Online Financial Tools and Resources

Access to budgeting apps (e.g., YNAB, Mint)

Retirement calculators

Debt payoff calculators

Investment simulators

Financial literacy courses (online)

Other (please specify):

Employer-Sponsored Financial Benefits

401(k) or retirement plan optimization

Health Savings Account (HSA) education

Employee stock purchase plan (ESPP) guidance

Student loan repayment assistance

Financial wellness stipends or bonuses

Other (please specify):

Additional Support Services

Credit counseling services

Legal assistance for financial matters

Mental health support for financial stress

Peer financial support groups

Other (please specify):

III. Employee Preferences

How do you prefer to receive financial wellness support?

In-person workshops

Virtual webinars

One-on-one sessions (in-person or virtual)

Self-paced online courses

Mobile apps or digital tools

Printed resources (e.g., guides, brochures)

Other (please specify):

How often would you like to participate in financial wellness programs?

Weekly

Bi-weekly

Monthly

Quarterly

As needed

What time of day works best for you to attend financial wellness sessions?

Morning (before work)

Lunch break

After work hours

Weekends

Flexible (anytime)

What is your current level of financial knowledge?

Beginner (just starting to learn)

Intermediate (some knowledge, but want to improve)

Advanced (confident in managing finances, but seeking optimization)

Do you have any specific financial concerns or challenges?

High levels of debt

Difficulty saving money

Lack of retirement savings

Confusion about investments

Stress related to financial decisions

Other (please specify):

IV. Confidentiality and Consent

I understand that the information provided in this form will be kept confidential and used solely for the purpose of tailoring financial wellness programs to my needs.

I consent to participate in the financial wellness programs offered by my employer.

Employee Signature:

V. Additional Comments or Requests

Please use the space below to share any additional comments, questions, or specific requests regarding financial wellness programs:

Form Template Insight

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Below is a detailed breakdown of the Financial Planning Assistance for Corporate Wellness Programs - Internal Employee Client Intake Form. This analysis explains the purpose of each section, the rationale behind the questions, and how the form can be used to design effective financial wellness programs.


1. Employee Information

Purpose:

  • To identify the employee and ensure the financial wellness program is personalized and accessible.
  • To maintain records for follow-ups and program tracking.

Key Insights:

  • Collecting the employee’s department and job title can help identify trends or common financial challenges within specific roles or teams.
  • Contact information ensures the employer can communicate program details effectively.

2. Section 1: Financial Wellness Goals

Purpose:

  • To understand the employee’s primary financial objectives and tailor programs to meet their needs.

Key Insights:

  • Employees may have diverse goals, such as debt reduction, retirement planning, or saving for emergencies. This section helps prioritize which programs to offer.
  • If many employees select "Debt reduction and management," the employer might focus on debt counseling or workshops.
  • If "Retirement planning" is a common goal, the employer could emphasize 401(k) optimization or retirement seminars.

3. Section 2: Preferred Financial Assistance Programs

Purpose:

  • To gauge employee interest in specific types of financial assistance programs.

Key Insights:

  • Financial Education Workshops: Employees may prefer learning in group settings. Popular topics can guide the employer in scheduling relevant workshops.
  • One-on-One Financial Coaching: Employees seeking personalized attention may benefit from individual sessions with financial experts.
  • Online Financial Tools and Resources: Tech-savvy employees may prefer self-paced learning through apps or online courses.
  • Employer-Sponsored Financial Benefits: This section highlights which benefits (e.g., 401(k), HSA) employees need help understanding or optimizing.
  • Additional Support Services: Employees may need holistic support, such as credit counseling or mental health resources for financial stress.

4. Section 3: Employee Preferences

Purpose:

  • To understand how employees prefer to engage with financial wellness programs.

Key Insights:

  • Delivery Method: Some employees may prefer in-person workshops, while others may favor virtual sessions or self-paced tools. This helps the employer choose the right format.
  • Frequency: Knowing how often employees want to participate ensures programs are neither overwhelming nor insufficient.
  • Timing: Scheduling sessions at convenient times (e.g., lunch breaks or after work) increases participation rates.
  • Financial Knowledge Level: This helps tailor the complexity of programs. Beginners may need basic budgeting workshops, while advanced employees may seek investment strategies.
  • Specific Concerns: Identifying challenges like high debt or retirement savings gaps allows the employer to address pressing issues.

5. Section 4: Confidentiality and Consent

Purpose:

  • To ensure employees feel secure sharing personal financial information.
  • To obtain formal consent for participation in financial wellness programs.

Key Insights:

  • Confidentiality is critical to building trust. Employees are more likely to participate if they know their information is secure.
  • A signed consent form ensures compliance with data protection regulations and formalizes the employee’s commitment to the program.

6. Section 5: Additional Comments or Requests

Purpose:

  • To provide employees with an opportunity to share unique needs or suggestions.

Key Insights:

  • This open-ended section can reveal unmet needs or innovative ideas for financial wellness programs.
  • For example, an employee might request support for managing student loans or guidance on saving for a child’s education.

How This Form Benefits the Employer and Employees

For Employers:

  1. Program Customization: The form provides actionable data to design programs that align with employee needs and preferences.
  2. Increased Engagement: By offering programs employees are interested in, participation rates are likely to improve.
  3. Targeted Support: Employers can identify common challenges (e.g., debt, retirement planning) and address them proactively.
  4. ROI Measurement: Tracking employee goals and participation helps measure the effectiveness of financial wellness programs.

For Employees:

  1. Personalized Support: Employees receive guidance tailored to their financial goals and challenges.
  2. Convenience: Programs are offered in preferred formats and at convenient times.
  3. Confidentiality: Employees can share sensitive information without fear of judgment or exposure.
  4. Holistic Wellness: Financial wellness programs reduce stress and improve overall well-being, leading to higher job satisfaction and productivity.

Implementation Tips for Employers

  1. Promote the Form: Use email, intranet, and team meetings to encourage employees to complete the form.
  2. Analyze Data: Use the responses to identify trends and prioritize program offerings.
  3. Communicate Clearly: Share the results and upcoming programs with employees to maintain transparency.
  4. Evaluate and Adapt: Regularly review program effectiveness and update offerings based on employee feedback.

This form is a powerful tool for creating a financially healthy workforce. By understanding employee needs and preferences, employers can design programs that not only improve financial literacy but also foster loyalty, reduce stress, and enhance overall productivity.


 

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