FINANCIAL PROTECTION ASSESSMENT

by Regie Durana, Financial Professional

Step 1 of 12

What concerns you most about your financial future?

Select all that apply to you.

Living too short
I worry about leaving my family unprotected if something happens to me
Living too long
I'm concerned about outliving my savings or running out of money in retirement
Getting seriously ill
I worry about being unable to work and provide for my family due to illness or injury
I'm not sure
I'd like help understanding what I should be thinking about

Who depends on you financially?

This helps determine the right level of protection.

I have children or dependents
My spouse or partner
I help support my parents
Just myself right now

What do you want financial protection to accomplish?

Select the goal that matters most to you.

Replace my income if I'm gone
Make sure my family can maintain their lifestyle
Cover final expenses and debts
Don't leave my family with bills to pay
Build savings and retirement income
Create wealth while I'm protected
All of the above

What is your age range?

Different solutions work better at different stages of life.

Under 30
30 to 45
45 to 60
60 or older

What best describes your employment?

This affects what options are available to you.

Employed (W-2)
Self-employed or business owner
No employer benefits — you need your own protection
Retired
Other / Not currently working

What is your approximate household income?

This helps me recommend appropriate coverage levels.

Under $50,000
$50,000 to $100,000
$100,000 to $200,000
$200,000 or more
Prefer not to say

Does your family have a history of chronic illness?

This helps identify if long-term care planning should be a priority.

Yes
Alzheimer's, dementia, heart disease, cancer, MS, or other chronic conditions
No known family history
I'm not sure

Do you currently have life insurance?

This helps me understand where you're starting from.

Yes, through my employer
Usually 1-2x your salary, and it ends if you leave your job
Yes, I have my own personal policy
No, I don't have any coverage
I'm not sure what I have

Do you have retirement savings?

401(k), IRA, pension, or other retirement accounts.

Yes, and I'm actively contributing
Building for the future
Yes, but not contributing right now
No retirement savings yet
Already retired and drawing from savings

Have you worked with a financial professional before?

No wrong answer here — just helps me understand your experience.

Yes, I currently work with one
Yes, but not anymore
No, this would be my first time

How soon do you want to address this?

This helps me prioritize your needs.

As soon as possible
This is a priority for me right now
Within the next 1-3 months
Just exploring my options
No rush — I'm gathering information

What's your monthly budget for protection?

There are quality options at every budget level.

Under $50 per month
$50 to $150 per month
$150 to $300 per month
$300 or more per month
I need help figuring this out
We can sit down together and find a comfortable number

Based on your answers, here's what I recommend

These solutions are tailored to your situation and concerns.

Your information is kept confidential

Book Your Free Strategy Session

Pick a time that works for you. No pressure, just an honest conversation about your options.

You're all set!

I look forward to speaking with you.

What happens next?

I'll review your answers and prepare some options tailored to your situation. When we talk, there's no pressure — just an honest conversation about what might work best for you and your family.