Intake form

Name *

Email address *

What type of financial services are you interested in?

Please select at least one option.

Financial planning

Insurance education

Investment advice

Retirement planning

Tax planning

Estate planning

What is your current employment status?

What is your age group?

Do you have any previous experience with financial or insurance services?

What is your preferred method of communication?

Are you a new canadian?

What is your primary financial goal?

Please select at least one option.

Saving for retirement

Buying a home

Paying off debt

Investing for growth

Protecting assets

Planning for education expenses

Do you currently have any insurance policies?

If yes, what type of insurance policies do you have?

Please select at least one option.

Life insurance

Health insurance

Disability insurance

Home insurance

Auto insurance

Would you like to schedule a consultation?

Additional questions or comments

Tim Seguin Financial Services ltd.