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Jennifer Thompson Money Coach
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First Name
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Last Name
Email Address
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Phone
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Skype ID
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Do you have Zoom on your computer or are you able to download it from the email sent to you after you booked your Insight Call?
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Yes
No
Maybe
Do you prefer a phone call or Zoom Room (Note if I am not in North America it will need to be over Zoom)
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Zoom Call
Phone Call
How did you learn about Jennifer Thompson? Did someone refer you? If so who?
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What is your relationship status?
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Married
Single
Divorced with Kids
Divorced with no Kids
What is holding you back from experiencing more joy and peace with money?
Fear and anxiety
Lack of financial literacy
Underearning
Overspending
Lack of self worth
Other
How do you make your money?
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Self employed (Business owner)
Employed (Salary)
Employed (Salary/Commissions)
Unemployed (relative, alimony, disability etc)
Other
What is your annual income?
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$10 000-$30 000
$30 000- $50 000
$50 000-$70 000
$70 000- $100 000
$100 000- $150 000
$150 000- $250 000
$250 000 plus
If you have debt, how would you describe your feelings around it?
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I don't worry about it. I pay it off in full each month
It's manageable and I have a plan to be debt free within the year
It feels scary
I don't want to talk about it.
I have no debt
Other
What's the most you have you invested in your personal/business development within one year?
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$0- I have never invested in my personal/business development before.
$1-$500
$500-$2000
$2000-$5000
$5000-$10000
$10000 plus
Other
If you could choose just one of the following outcomes, which is the most meaningful to you?
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Less stress and worry
Abundant and joyful
Confident and empowered
Better communication between my partner
What have you tried in the past to shift the challenges you face with your money?
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Why do you believe your past efforts have not worked?
On a scale of 1-10 how confident are you that you can change your money situation on your own without any help?
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1
2
3
4
5
6
7
8
9
10
Briefly describe a time in your life when you felt fantastic. What activities did you do and how did they make you feel?
If someone advised me to spend a chunk of money to create a strong financial foundation for my money, I would…
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know that I need help and I haven't been able to fix this on my own.
be a little gun shy because I'm already not meeting my financial obligations.
avoid spending anymore money because it scares me too much.
Other
Right now, I...
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Have the financial resources to invest in healing my relationship with money
Have access to the financial resources to invest in my financial health and growth.
Do not have any financial resources at all but I want to see if I can make it work.
Other
If you could have dinner with anyone, dead or alive, who would you invite to your table and why?
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