Free Financial Health Survey

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Age	18-25 26-35 36-45 46-55 56 and above
Gender	Male Female Prefer not to say
Marital Status	Single Married Divorced Widowed
Education Level	High School or Below College/University Postgraduate
Employment Status	Employed Full-Time Employed Part-Time Unemployed Self-Employed

Source	Monthly Amount ($)
Employment	[0]
Investments	[0]
Other	[0]
Total Income	[0]

Expense	Monthly Amount ($)
Housing	[0]
Utilities	[0]
Food	[0]
Transportation	[0]
Entertainment	[0]
Total Expenses	[0]

Type	Presence
Savings Account	Yes No
Investment Portfolio	Yes No

Type	Amount ($)
Mortgage	[0]
Auto Loans	[0]
Credit Cards	[0]
Student Loans	[0]
Total Debt	[0]

Free Financial Health Survey

I. Demographic Information

II. Income and Expenses

A. Household Income

B. Monthly Expenses

C. Savings and Investments

III. Debt Profile

IV. Financial Goals and Planning

A. Short-Term Financial Goals

B. Long-Term Financial Goals

C. Retirement Planning

V. Financial Literacy

A. Basic Financial Knowledge:

B. Sources of Financial Information:

VI. Financial Well-being Perceptions

A. Self-assessment of Financial Well-being:

B. Factors Influencing Financial Satisfaction:

VII. Emergency Preparedness

A. Emergency Savings:

VIII. Access to Financial Services

A. Banking Services Utilized:

B. Access to Credit:

C. Perceptions of Economic Conditions:

D. Confidence in Job Security:

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Goal	Target Amount ($)
Contributing to Retirement Accounts	[0]
Estimated Retirement Age	[0]

Savings Goal	Current Progress ($)	Target Amount ($)
Short-Term Emergencies	[0]	[0]
Medical Expenses	[0]	[0]