Financial Coaching Intake

About You

C5iSR coaching is for individuals and families who want to align their finances with their faith — and build real wealth from a place of stewardship, not fear. Let's start with who you are.

Your financial information is kept strictly confidential and never shared. This intake exists to help your coach provide the best possible guidance.

First Name *

Last Name

Age

Email

Phone

Marital status

Single

Married

Divorced

Widowed

Number of dependents

0

1

2

3

4+

Employment status

Employed (W-2)

Self-employed

Business owner

Military / Veteran

Retired

Unemployed

Current Financial Picture

No judgment here — we need to know where you're starting from to map the path forward. Be as honest as you can. Ranges are fine.

Household income range (annual)

Under $40k

$40k–$75k

$75k–$125k

$125k+

Prefer not to say

Monthly cash flow — how does income vs. expenses look right now?

In deficit (spending more)

Breaking even

Small surplus

Building wealth

Current debt situation

No debt

Under $10k

$10k–$50k

$50k+

Types of debt you currently carry (select all that apply)

Credit cards

Student loans

Auto loans

Mortgage

Medical debt

Business debt

Personal loans

None

Assets & Investments

Let's build a clear picture of what you already have. This helps your coach see your full financial landscape, not just the gaps.

Savings

Do you have savings?

Yes

No

Just starting

Savings amount range (if applicable)

Under $1k

$1k–$10k

$10k–$50k

$50k+

Prefer not to say

Traditional Investments

Do you invest in stocks, ETFs, mutual funds, or retirement accounts?

Yes

No

Only 401k / employer plan

Crypto

Do you own cryptocurrency?

Yes

No

Interested but haven't started

If yes — which coins/assets? (optional)

Physical Assets

Other assets you hold

Physical gold / silver

Real estate

Business / LLC equity

Life insurance / annuities

None of these

Biblical Stewardship

C5iSR coaching is rooted in the conviction that everything we have belongs to God — and we're stewards, not owners. This section helps your coach understand where faith and finances intersect for you.

Do you tithe?

Yes — consistently

Sometimes

Not currently

Working toward it

On a scale of 1–10, how much does your current financial plan reflect your faith values?

5

1 — Not at all10 — Fully aligned

Biggest money struggle right now

Fear / Anxiety

Overspending

Debt

Don't know where to start

Lack of income

Inconsistency

Other

How has your faith shaped how you think about money?

Financial Goals

The plans of the diligent lead to profit. Let's build yours. What are you working toward?

Primary financial goal

Debt freedom

Emergency fund

Investment growth

Passive income

Generosity / Giving

Crypto strategy

Estate / Legacy planning

Additional goals (select all that apply)

Build a budget that works

Increase income

Retire early

Fund a business

Real estate investing

Protect my family financially

Leave an inheritance

Give more generously

Your 6-month goal — in your own words

Your 5-year vision

₿ Crypto & Digital Assets

C5iSR specializes in Christ-centered crypto strategy. This section applies if you're currently in crypto or curious about it. Skip anything that doesn't apply to you yet.

Crypto experience level

Complete beginner

Learning / Just started

Intermediate

DeFi / Advanced

Not interested

Crypto strategies you're interested in (select all that apply)

Bitcoin strategy (long-term hold)

Altcoins

Stablecoins

Yield farming / DeFi

Trading bots / Automation

NFTs / Digital ownership

None — not interested in crypto

Current crypto holdings (optional — ranges fine)

What's your biggest fear or question about crypto?

Readiness to Change

Financial transformation requires more than knowledge — it requires commitment to change behavior. How ready are you?

On a scale of 1–10, how ready are you to make real changes to your finances right now?

7

1 — Just curious10 — All in, starting today

What has held you back from getting financial coaching or fixing your finances before?

Didn't know where to start

Cost / couldn't afford it

Fear / shame around money

Tried budgets, never stuck

Partner wasn't on board

Income was the problem

Didn't trust financial advisors

This is my first time

Anything else you want Adam to know before your first session?

Review & Submit

Review your coaching intake below, then submit. Adam will reach out within 24 hours to schedule your first C5iSR session.

Your Stewardship Journey Begins

Your intake is submitted. Adam will reach out within 24 hours.

"The plans of the diligent lead to profit as surely as haste leads to poverty."

— Proverbs 21:5

C5iSR · Adam Johns · Stewardship Note

Wealth isn't the enemy — misaligned priorities are. God calls us to be faithful with what He gives us. Whether you're starting from zero or building on a solid foundation, we start where you are and work toward where God is calling you. The diligent plan. We're going to build yours together.

Ready to lock in your first coaching session?

Book Your C5iSR Coaching Session