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Confidential client questionnaire

Client Intake Form

Help us understand your financial goals, questions, and current priorities so we can prepare for a useful first conversation. Elevate services are provided at no cost.

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Personal Information

Tell us how to contact you.

Service Interest

What are you interested in today? Check all that apply. *

The next questions will adjust automatically based on what you select.

Timing

How soon would you like to begin working on your selected goals? *

Preparing Your Documents

While you wait for our response, please begin gathering any documents that may help us better understand your financial picture. Helpful items may include recent bank statements, a current budget, credit reports, loan or credit card interest rates, and relevant account summaries.

Please do not submit these documents through this website or send them by email yet.Elevate will contact you directly if documents are needed and provide instructions for what to send.

Final Notes

Client Acknowledgment and Disclosure

Nonprofit Status: Elevate Inc. is a nonprofit organization that provides financial education, budgeting assistance, and general investment knowledge at no cost.

Professional Services Boundary: Individualized financial planning, financial advice, investment advice, investment recommendations, portfolio analysis, and other professional advisory services are separate professional services and are not included in Elevate Inc.'s free assistance. Completing this form does not create a financial advisory or investment advisory relationship.

Educational Information: Information provided through Elevate Inc.'s free services is for general educational purposes and is not a recommendation to buy, sell, or hold any investment.

Client Responsibility: I remain responsible for my financial decisions.

Electronic Signature Certification

By typing my full name below and submitting this form, I certify that I am the person named in this form and intend my typed name to serve as my electronic signature.

For the signature record, Elevate Inc. will retain the typed name, certification, submission date and time, IP address, and browser information submitted with this form.

Request an Appointment

Appointments normally last 30 to 45 minutes and are available Monday through Friday from 1:00 p.m. to 4:00 p.m. Central Time. Weekend appointments cannot be requested through this form.

Saturdays may be used separately for first-come, walk-in, mentorship, or open community conversations and are not appointment-based.Bring or have available all documents you would like Elevate to review.
Final required step: Choose three availability options. Selecting Submit Intake will send the completed form to Elevate and open the prepared message in your phone’s messaging app. This is a request, not a confirmed appointment.

How would you like to meet?

Availability choice 1
Availability choice 2
Availability choice 3

Your responses are sent directly to Elevate Inc. only after you complete the appointment request. They are not sold or used for advertising. Do not enter Social Security numbers, account numbers, passwords, or other highly sensitive information.