Client Questionnaire

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You can skip anything you would rather discuss in person. Nothing on this form is required.

Your information stays confidential. Everything you enter is transmitted over a secure connection and is seen only by Brett Goodman and firm staff working on your matter. Nothing here creates an attorney-client relationship on its own.

Your Information

You

Your full name

Date of birth

Phone

Address

Spouse (if applicable)

Spouse full name

Date of birth

Phone

Children

Child's full name

Date of birth

II.

Beneficiaries

Who should get your assets when you pass away?

Name

Percentage or dollar amount

Backup plan

If any or all of the people above should pass away before you, who should receive their portion instead?

A short note is plenty. We will walk through the details together.

III.

Successor Trustees

Who should be in charge of handling the paperwork and making those distributions?

First choice

Second choice

Third choice

IV.

Power of Attorney

If you become incapacitated, who should help handle your finances?

You

Your first choice

Your second choice

Your third choice

Spouse (if applicable)

Your spouse's first choice

Your spouse's second choice

Your spouse's third choice

Advance Health Care Directive

If you become incapacitated, who should be your medical liaison?

You

Your first choice

Your second choice

Your third choice

Spouse (if applicable)

Your spouse's first choice

Your spouse's second choice

Your spouse's third choice

VI.

Guardians

Who should your minor children live with?

First choice

Second choice

Third choice

VII.

Assets

This section helps us understand what needs to be included in your plan.

Please do not enter account numbers, Social Security numbers, passwords, or private keys anywhere on this form. We will never ask for them by email or through our website. Bring those details with you to your consultation instead.

Which of these do you have?

Check all that apply. Checking a box opens a few short follow-up questions below.

Real EstateBank or Credit Union AccountsBrokerage or Investment AccountsRetirement AccountsLife Insurance / AnnuitiesBusiness or Partnership InterestsCryptocurrency / Digital AssetsVehicles, Boats or AircraftValuable CollectionsMoney Owed To YouExpected InheritanceFirearmsPetsFamily ConcernsNone of These

Check a box above and its questions will appear here.

Real Estate

For each property you own:

Property address

Type
Primary ResidenceSecond HomeRental or InvestmentLandOther

Bank Accounts

Bank or credit union name

List more than one if you use several. No account numbers, please.

Types of accounts held
CheckingSavingsCDMoney Market

Do you have a safe deposit box?

If so, where is it, and who else has access?

Non-Retirement Investments

Firm or institution

Brokerage, financial advisor, or held directly.

Advisor name and contact (if you have one)

What is held

Brokerage accountIndividual stocks or bondsMutual funds or ETFsEmployer stock or stock options529 or education savingsOther

Retirement Accounts

Institution or plan administrator

Account type
401(k)403(b)Traditional IRARoth IRASEP IRASIMPLE IRAPensionInherited IRAOther

Whose account is it?
MineSpouse

Life Insurance and Annuities

Insurance company

Policy type
TermWhole lifeUniversal or variableGroup coverage through workAnnuity

Do you have long-term care insurance?
YesNoNot sure

Business Interests

Business name

Entity type
LLCS corporationC corporationPartnershipSole proprietorshipProfessional corporationNot sure

State where it is formed

Other Assets

Do you own cryptocurrency or other digital currency?

YesNo

If yes, where is it held?

Do not enter wallet addresses, seed phrases, or private keys.

On an exchange (Coinbase, Kraken, and similar)In a self-custody walletBoth

Vehicles, boats, RVs, or aircraft

Valuable collections

Art, jewelry, antiques, coins, wine, memorabilia.

Money owed to you

Promissory notes, loans to family, seller-financed sales.

Are you the beneficiary of anyone else's trust, or do you expect an inheritance?

Do you own firearms?

YesNo

Do you have pets you would want provided for?

YesNo

Anything else significant not covered above

The Big Picture optional, but helpful

Is there anything about your family or finances that makes your situation complicated?

For example, a blended family, a beneficiary with special needs, an estranged relative, or a family disagreement. A sentence or two is plenty.

Prefer to work on paper?
Download the printable version
and bring it to the office.

Not ready to fill this out yet? Schedule a free consultation and we will walk through it together.