Biblical Financial Counseling Intake
Personal Information
Full Name
Date
Email
Phone
Address
Family & Household
Marital Status
Single
Married
Divorced
Widowed
Number of Dependents
Church Information
Home Church
Pastor/Elder Contact (if applicable)
Financial Situation
Current Employment Status
Estimated Monthly Household Income
Estimated Monthly Expenses
Outstanding Debts (list and amounts)
Assets (list and approximate values)
Reason for Seeking Counseling
Please briefly describe the main concerns or areas where you are seeking biblical financial guidance:
Goals
What are your goals or desired outcomes for this counseling?
Additional Information
Is there anything else you would like your counselor to know?