5405 Morehouse Drive, Suite 245, San Diego, CA 92121

BStevens@BAS-Financial.com

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Personal & Family Concerns Assessment

Personal & Family Concerns Assessment

Personal & Family Concerns Assessment

Client Information

Name Email Phone Date

Spouse / Partner Information (if applicable)

Name Email Phone

Priority Scale:
1 = Low Priority 5 = High Priority

Financial Organization

Getting Financially Organized

1 2 3 4 5

Protection & Insurance Planning

Life Insurance

1 2 3 4 5

Disability Income Protection

1 2 3 4 5

Long‑Term Care Insurance / Family Health Planning

1 2 3 4 5

Property & Casualty (Auto, Home, Umbrella)

1 2 3 4 5

Cash Management

Personal Cash Flow / Budget Management

1 2 3 4 5

Debt Reduction / Credit Lines

1 2 3 4 5

Liquidity / Emergency Fund

1 2 3 4 5

Savings Strategies

1 2 3 4 5

Tax Strategies

Income Tax Efficiencies

1 2 3 4 5

Capital Gain / Business / Estate Tax Efficiencies

1 2 3 4 5

Estate Planning

Wills & Trusts

1 2 3 4 5

Medical Directives

1 2 3 4 5

Durable Power of Attorney

1 2 3 4 5

Multi‑Generational Planning

1 2 3 4 5

Special Needs Planning

1 2 3 4 5

Planned Giving

1 2 3 4 5

Wealth & Asset Management

Capital Gains Management

1 2 3 4 5

Portfolio Tax Efficiency

1 2 3 4 5

Asset Allocation

1 2 3 4 5

Investment Strategies

1 2 3 4 5

Retirement Planning

How Much Is Enough to Retire

1 2 3 4 5

Retirement Income Strategies

1 2 3 4 5

Family Planning

College & Education Funding

1 2 3 4 5

Workplace Benefits

Medical / Dental / Vision

1 2 3 4 5

Group Life / Disability

1 2 3 4 5

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Contact

Office: (858) 335-4945

Office: (909) 307-4945

5405 Morehouse Drive

Suite 245

San Diego, CA 92121

CA Life and Health, Series 7, 6, 63, 65

BStevens@BAS-Financial.com

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BAS Financial | San Diego Wealth Coordination 5405 Morehouse Drive, Suite 245 San Diego, CA 92121 Serving clients across San Diego, La Jolla, and the Inland Empire. (858) 335-4945

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