Company Name
Contact Person
Job Title
Email Address
Phone Number
Company Size (Number of Employees)
Industry/Sector
What are your primary goals for offering debt management education to your employees? (Check all that apply)
Improve employee financial wellness
Reduce financial stress among employees
Increase employee productivity
Enhance employee retention and satisfaction
Other (please specify):
Are there any specific challenges your employees face regarding debt management? (e.g., card debt, student loans, mortgages, etc.)
Please indicate which debt management topics you would like to include in the program. (Check all that apply)
Budgeting and Financial Planning
Creating a personal budget
Tracking expenses
Setting financial goals
Understanding Debt
Types of debt (secured vs. unsecured)
How interest rates work
The impact of credit scores on debt
Debt Repayment Strategies
Snowball method
Avalanche method
Debt consolidation options
Credit Management
How to read a credit report
Improving credit scores
Avoiding card debt
Student Loan Management
Understanding student loan terms
Repayment options (e.g., income-driven plans)
Loan forgiveness programs
Mortgage and Housing Debt
Understanding mortgage terms
Refinancing options
Avoiding foreclosure
Managing Medical Debt
Negotiating medical bills
Payment plans and financial assistance
Impact of medical debt on credit
Behavioral Finance and Debt
Understanding spending habits
Emotional triggers for debt
Building healthy financial habits
Retirement and Debt
Balancing debt repayment with retirement savings
Understanding the impact of debt on retirement planning
Legal Aspects of Debt
Debt collection laws
Bankruptcy options
Consumer rights and protections
What format would you prefer for the debt management education program? (Check all that apply)
In-person workshops
Virtual webinars
On-demand video modules
Printed materials (e.g., guides, handouts)
One-on-one financial coaching sessions
Other (please specify):
How long should each session be?
30 minutes
60 minutes
90 minutes
Other (please specify):
How frequently should the sessions be offered?
Once
Monthly
Quarterly
Other (please specify):
How would you like employees to enroll in the program?
Mandatory participation
Voluntary sign-up
Department-specific enrollment
Other (please specify):
Do you have any preferences for incentivizing employee participation? (e.g., rewards, recognition, etc.)
Would you like to include anonymous surveys or feedback forms to assess employee satisfaction and program effectiveness?
Are there any specific demographics or employee groups you would like to target? (e.g., new hires, mid-career employees, pre-retirees, etc.)
Do you have any existing financial wellness programs or resources in place?
Are there any budget constraints or limitations we should be aware of?
Any other comments or special requests?
By signing below, you authorize the implementation of the debt management education program as outlined in this intake form.
Authorized Signature