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Intake Questions
First Name
Last Name
Email Address
Phone Number
1. Please select which plan you currently have in place:
Last Will & Testament
Durable Power of Attorney
LivingWill
Designation of Healthcare Surrogate
TrustAccount
Guardianship (for minor children)
None of the above
2. Do you have minor children?
3. Do you have an existing life plan document currently in place?
4. Do you have a life insurance plan in place?
5. Are you interested in discussing your end-of-life preparation? (funeral arrangements)
Yes
No
6. Are you a business owner?
Yes
No
If so, do you have a succession plan in place
Yes
No
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