Debt Management Education for Corporate Wellness Programs Client Intake Form


Corporate Client Information

Company Name

Company Address






Contact Person

Title

Phone Number


Email Address

Company Industry

Number of Employees Participating (Estimated)

Program Preferences

Preferred Format for Debt Management Education

Preferred Duration of Sessions

Preferred Frequency of Sessions

Target Audience

Debt Management Topics of Interest

Please indicate the level of interest for each topic (1 = Not Interested, 5 = Very Interested)

Topic

Rating

(1=Not Interested, 5=Very Interested)

1

Budgeting and Financial Planning

2

Understanding and Managing Debt

3

Credit Score Improvement

4

Debt Repayment Strategies

5

Student Loan Management

6

Mortgage and Housing Debt

7

Managing Card Debt

8

Bankruptcy and Debt Relief Options

9

Financial Wellness and Mental Health

10

Retirement Planning and Debt

Additional Preferences

Language Preferences

Customization Needs

Employee Engagement Tools

Follow-Up Support

Program Goals

What are your primary goals for offering debt management education?

How will you measure the success of the program?

Budget and Timeline

What is your budget for this program?

Preferred Start Date

Preferred End Date

Additional Comments or Requests

Please provide any additional information or special requests

Authorization and Submission

By submitting this form, you authorize us to use the provided information to design a customized debt management education program for your organization.


Signature

Form Template Insight

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Below is a detailed breakdown of the Debt Management Education for Corporate Wellness Programs Client Intake Form. This analysis explains the purpose of each section, the rationale behind the questions, and how the information gathered can be used to design an effective and tailored debt management education program for corporate clients.


1. Corporate Client Information

This section collects basic details about the company and the primary contact person. It helps in understanding the client's organizational structure and size, which is crucial for tailoring the program to their specific needs.


  • Company Name, Contact Person, Job Title, Email, and Phone Number: These fields ensure clear communication and accountability throughout the program design and implementation process.
  • Company Size: The number of employees helps determine the scale of the program, whether it’s for a small team or a large organization. It also influences the format (e.g., small workshops vs. large webinars).
  • Industry: Different industries may have unique financial challenges (e.g., student loan debt in education, high card debt in retail). Knowing the industry helps tailor content to address sector-specific issues.

2. Program Preferences

This section focuses on how the client envisions the program being delivered. It ensures the format, duration, and frequency align with the company’s culture and employee availability.

  • Preferred Format: Options like in-person workshops, virtual webinars, or on-demand modules cater to different employee preferences and logistical constraints (e.g., remote workforces may prefer virtual options).
  • Duration and Frequency: These questions help balance the depth of content with employee availability. For example, shorter, more frequent sessions may work better for busy employees.
  • Target Audience: Identifying the audience ensures the program is relevant. For example, entry-level employees may need basic budgeting skills, while executives may benefit from advanced debt management strategies.

3. Debt Management Topics of Interest

This section identifies the specific areas of debt management that are most relevant to the client’s employees. It ensures the program addresses their most pressing financial concerns.

  • Budgeting and Financial Planning: A foundational topic that helps employees manage their income and expenses effectively.
  • Understanding and Managing Debt: Provides a broad overview of debt types and strategies to manage them.
  • Credit Score Improvement: Essential for employees looking to improve their financial health and access better loan terms.
  • Debt Repayment Strategies: Focuses on practical methods like the debt snowball or avalanche approach.
  • Student Loan Management: Particularly relevant for younger employees or those in education-related industries.
  • Mortgage and Housing Debt: Important for employees navigating homeownership or rental challenges.
  • Managing Card Debt: Addresses high-interest debt, which is a common financial stressor.
  • Bankruptcy and Debt Relief Options: Provides information on last-resort solutions for employees in severe financial distress.
  • Financial Wellness and Mental Health: Highlights the connection between financial stress and overall well-being.
  • Retirement Planning and Debt: Helps employees balance debt repayment with long-term savings goals.
  • Other Topics: Allows clients to suggest additional areas of interest not covered in the standard list.

4. Additional Preferences

This section ensures the program is accessible, engaging, and aligned with the company’s culture.

  • Language Preferences: Ensures inclusivity for non-English-speaking employees.
  • Customization Needs: Tailoring content to the company’s specific context (e.g., industry examples) increases relevance and engagement.
  • Employee Engagement Tools: Interactive elements like quizzes, surveys, and gamification make the program more engaging and effective.
  • Follow-Up Support: Ongoing support (e.g., coaching, newsletters) ensures employees can apply what they’ve learned and sustain positive financial habits.

5. Program Goals

This section clarifies the client’s objectives for offering the program, which helps in designing measurable outcomes.

  • Primary Goals: Whether the focus is on reducing stress, improving literacy, or boosting productivity, understanding the goals ensures the program delivers value.
  • Success Metrics: Defining how success will be measured (e.g., surveys, participation rates) ensures accountability and allows for program adjustments if needed.

6. Budget and Timeline

This section ensures the program is feasible and aligns with the client’s financial and scheduling constraints.

  • Budget: Knowing the budget helps in designing a program that fits within the client’s financial limits while still delivering value.
  • Timeline: A clear start and end date ensure the program is delivered on time and aligns with the company’s schedule.

7. Additional Comments or Requests

This open-ended section allows the client to provide any extra information or special requests that haven’t been covered in the form. It ensures the program is as customized as possible.

8. Authorization and Submission

This final section formalizes the client’s agreement to proceed with the program design based on the provided information.


How This Form Benefits the Corporate Client

  1. Tailored Content: The form ensures the program addresses the specific financial challenges and interests of the employees.
  2. Employee Engagement: By incorporating preferred formats and engagement tools, the program is more likely to resonate with employees and encourage participation.
  3. Measurable Outcomes: Clear goals and success metrics allow the client to evaluate the program’s impact and ROI.
  4. Logistical Feasibility: By understanding budget and timeline constraints, the program can be designed to fit seamlessly into the company’s operations.
  5. Inclusivity and Accessibility: Language preferences and customization options ensure the program is accessible to all employees, regardless of their background or financial literacy level.

How This Form Benefits the Service Provider

  1. Clear Direction: The form provides a structured way to gather all necessary information, reducing the risk of miscommunication or overlooked details.
  2. Efficient Planning: With all preferences and constraints outlined, the service provider can design the program more efficiently.
  3. Client Satisfaction: A highly customized program increases the likelihood of client satisfaction and repeat business.
  4. Data-Driven Design: The form’s detailed insights allow for a data-driven approach to program design, ensuring it meets the client’s needs effectively.

In summary, this intake form is a comprehensive tool for gathering the information needed to design a debt management education program that is tailored, engaging, and impactful for corporate clients and their employees.

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