Financial Planning Assistance for Corporate Wellness Programs Client Intake Form

Date

I. Client Information

Company Name

Contact Person

Job Title


Phone Number

Email Address

Company Address

City

State

Zip Code


Industry

Number of Employees

II. Current Corporate Wellness Program (if applicable)

Do you have any existing wellness initiatives?

What are the current goals of your wellness program?

What are the perceived strengths and weaknesses of your current program?

What is the current budget allocated to the wellness program?

III. Financial Planning Assistance Program Options

Please indicate which of the following financial planning assistance programs you are interested in offering to your employees. (Check all that apply)

Financial Education Workshops/Seminars:

Topics of interest:

Preferred format:

Desired frequency:

Individual Financial Counseling/Coaching:

Preferred delivery method:

Desired level of personalization:

Online Financial Planning Tools and Resources:

Types of tools/resources desired:

Preferred platform integration:

Retirement Planning Assistance

Specific retirement plan assistance needed:

Desired level of employee access to financial advisors:

Debt Management Programs

Interest in programs focused on:

Desired program features:

Employee Stock Option Plan (ESOP) and Equity Compensation Education

Interest in ESOP or other equity compensation education:

Desired education focus:

Emergency Savings Programs

Interest in implementing programs that encourage emergency savings:

Desired program features:

IV. Program Preferences and Goals

What are your primary goals for implementing a financial planning assistance program?

What is your desired level of employee participation in the program?

What are your key performance indicators (KPIs) for measuring the success of the program?

What is your desired timeframe for implementing the financial wellness program?

What is your budget range for this program?

Are there any specific employee demographics or needs that should be considered when designing the program?

What are the biggest financial concerns you believe your employees have?

V. Additional Information

Is there any other information you would like to share?


Thank you for completing this form. We will review your information and contact you to discuss your financial planning assistance program options.


Form Template Insight

Please remove this form template insight section before publishing.


Let's break down the detailed insights into this client intake form, section by section, to understand its purpose and effectiveness:


1. Client Information:


Purpose: This section establishes the basic contact information for the client company. It ensures accurate communication and record-keeping.

Insights:

  • "Number of Employees" is crucial. It directly impacts the scope, scale, and cost of the wellness program.
  • "Industry" provides context. Certain industries may have specific financial challenges or demographic profiles that need to be addressed.
  • Having the title of the contact person is important to know their level of authority in decision making.

2. Current Corporate Wellness Program (if applicable):


Purpose: This section aims to understand the client's existing wellness initiatives. It helps identify gaps and opportunities for integration.

Insights:

  • "Do you currently have a corporate wellness program?" This is a fundamental question to determine the client's starting point.
  • "What are the current goals of your wellness program?" This reveals the client's priorities and allows for alignment of financial planning assistance with those goals.
  • "What are the perceived strengths and weaknesses of your current program?" This helps to avoid repeating mistakes and to build on the existing strengths.
  • "What is the current budget allocated to the wellness program?" This provides a baseline for financial considerations and helps in suggesting appropriate programs.

3. Financial Planning Assistance Program Options:


Purpose: This is the core of the form. It presents a comprehensive list of potential financial wellness programs and allows the client to indicate their preferences.

Insights:

  • Variety of Options: Offering a range of options (workshops, counseling, online tools, retirement planning, debt management, ESOP education, emergency savings) demonstrates the breadth of expertise and allows for customization.
  • Specific Questions: Each program option is followed by specific questions to delve deeper into the client's needs and preferences. This ensures that the program is tailored to their unique requirements.
  • Format and Delivery: Questions about preferred formats (in-person, virtual, hybrid) and delivery methods (one-on-one, phone, online) are essential for logistical planning and employee engagement.
  • Level of Personalization: Questions about desired levels of personalization (general advice vs. comprehensive planning) help to determine the appropriate level of service.

4. Program Preferences and Goals:


Purpose: This section focuses on the client's overall objectives for implementing a financial wellness program.

Insights:

  • Primary Goals: Identifying the client's primary goals (employee well-being, productivity, retention) helps to measure the success of the program.
  • Employee Participation: Determining the desired level of employee participation (voluntary, encouraged, mandatory) is crucial for program design and implementation.
  • Key Performance Indicators (KPIs): Asking about KPIs encourages the client to think about how they will measure the effectiveness of the program.
  • Timeframe and Budget: These questions provide essential information for project planning and resource allocation.
  • Employee Demographics and Needs: This highlights the importance of considering diversity and inclusion when designing the program.
  • Employee Financial Concerns: This question gives valuable insight into the financial issues that employees are dealing with.

5. Additional Information:


Purpose: This section provides an open-ended opportunity for the client to share any other relevant information.

Insights:

  • This allows for the capture of any unique requirements or concerns that may not have been addressed in the previous sections.

Overall Effectiveness:

  • Comprehensive: The form covers a wide range of topics, ensuring that all essential information is gathered.
  • Client-Centric: The questions are designed to understand the client's needs and preferences, rather than simply promoting a specific product or service.
  • Actionable Insights: The information gathered from the form can be used to develop a customized financial wellness program that meets the client's specific requirements.
  • Professionalism: The form is well-organized and clearly written, projecting a professional image.

Potential Improvements:

  • Digital Version: Consider creating a digital version of the form for easier completion and data collection.
  • Checkboxes vs. Open-Ended Questions: While open-ended questions are valuable, consider adding more checkboxes for common responses to streamline the process.
  • Clarity on Confidentiality: Adding a statement about the confidentiality of the information provided can build trust with the client.
  • Follow-Up Plan: Consider adding a section outlining the next steps in the process, such as a scheduled consultation.

By implementing this detailed intake form, you can effectively gather the necessary information to create a successful and impactful financial wellness program for your clients.

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