Financial Durability Questionnaire Form
Please complete this questionnaire to help assess your current financial durability and resilience. Your responses are confidential and do not require any sensitive account or identification details.
Full Name
*
First Name
Last Name
Age Group
*
Please Select
Under 25
25-34
35-44
45-54
55-64
65 or older
How stable do you consider your primary source of income?
*
Very stable
Somewhat stable
Uncertain
Unstable
How would you rate your current monthly expense burden?
*
Very low
1
2
3
4
Very high
5
1 is Very low, 5 is Very high
How many months could your savings cover your essential expenses if your income stopped?
*
None
Less than 1 month
1-3 months
4-6 months
More than 6 months
How much pressure do you feel from debts or loans (if any)?
*
No pressure
1
2
3
4
Extreme pressure
5
1 is No pressure, 5 is Extreme pressure
How prepared are you for unexpected financial emergencies?
*
Not at all
1
2
3
4
Very well prepared
5
1 is Not at all, 5 is Very well prepared
In the past 12 months, how often have you struggled to make payments for essentials (e.g., rent, utilities, food)?
*
Never
Rarely
Sometimes
Often
Almost always
How optimistic are you about your financial situation over the next year?
*
Very pessimistic
1
2
3
4
Very optimistic
5
1 is Very pessimistic, 5 is Very optimistic
Briefly describe your overall sense of financial resilience.
Submit
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