Financial Stress Assessment Survey

Financial Stress Assessment Survey — Form Fields

This surveys template includes 8 fields. Gauge the financial stress levels and concerns of individuals to guide resource and support planning. Free to customize and use on ZenBuild.

• Employment Status (dropdown selection, required) — options: Full-Time, Part-Time, Self-Employed, Unemployed, Retired, Student
• Household Size (dropdown selection, required) — options: 1, 2, 3-4, 5+
• Current Financial Stress Level (rating, required)
• Do you have an emergency fund? (multiple choice, required) — options: Yes (3+ months), Yes (1-2 months), No, Currently Building One
• Top Financial Worries (checkboxes, optional) — options: Monthly Bills, Debt, Housing Costs, Retirement Savings, Healthcare, Job Security, Education Costs
• Confidence Managing Finances (rating, required)
• Have you sought financial counseling? (multiple choice, required) — options: Yes, No, Considering It
• What financial support would help most? (long text, optional)