Discovery - Altitude Wealth Management

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Please take a few minutes to introduce yourself and complete the form below. Upon submission, you'll be directed to the next step.

First name*

Last name*

Preferred name

Phone*

Email*

Privacy*

I agree to the privacy policy.

We're a relationship business that is built on referrals from others for the good work that we do. There's a good chance we already know a family member, colleague, or friend of yours.

This is why we take your privacy and the security of your financial information very seriously. So, before we go any further, we'll need you to confirm you understand and accept our Privacy Policy.

Date of Birth

Country of birth

Country

Residential suburb

Residential state*

Do you have a partner?*

Yes

Are you comfortable with us sharing and discussing your own personal financial details with your partner?

Yes

Tick this box to agree and consent to us sharing and discussing your personal financial details with your partner.

Partner's first name*

Partner's last name*

Partner's preferred name

Partner's date of birth

Partner's phone number

Partner's email

Does your partner have a different residential or postal address*

Yes

Partner's address

Street Address Suburb State Post Code Country

Is their postal address the same as their residential address?

Yes

Partner's postal address

Street Address Suburb State Post Code Country

Which service is of most interest to you?

Strategic advice

Investment management

Retirement planning

Aged care advice

Other

If other, please specify.

How do you feel about your current financial position?

Comfortable

Unsure

Concerned

What best describes why you feel that way?

I'm confident I have enough

I think I’ll be okay but haven’t checked recently

I’m not sure what I’ll need

I don’t think I’ll have enough

What is your personal income from employment?

No employment income

$0 - $49,999

$50,000 - $99,999

$100,000 - $149,999

$150,000 - $199,999

$200,000 - $250,000

Over $250,000

I prefer not to say

What other sources of income do you have personally?

Centrelink Pensions or Allowances

Investment income (such as dividends or distributions)

Rental property income

Non-government pension income (such as an Account Based Pension)

Business income

How many investment properties do you have?

How many investment properties do you and your partner have?

What is your approximate total balance of your investments outside of property and superannuation?

No investments outside of property or super in my name

$0 - $49,999

$50,000 - $99,999

$100,000 - $249,999

$250,000 - $499,999

$500,000 - $1,000,000

Over $1,000,000

I prefer not to say

What is your approximate combined total balance of your investments outside of property and superannuation?

Include assets in your name, your partners name, and any jointly held assets.

No investments outside of property or super

$0 - $49,999

$50,000 - $99,999

$100,000 - $249,999

$250,000 - $499,999

$500,000 - $1,000,000

Over $1,000,000

I prefer not to say

What is your approximate total superannuation balance personally?

No superannuation based policies in my name

$0 - $249,999

$250,000 - $499,999

$500,000 - $999,999

$1,000,000 - $1,999,999

$2,000,000 - $3,000,000

Over $3,000,000

I prefer not to say

Please list the names of any superannuation funds you personally have open.

Don't worry about checking your superannuation. If we know about the fund, we'll check there ourselves.

Please list the names of any life insurance policies you have.

Life insurance would include anything called 'Term Life', 'Total & Permanent Disability (TPD) Insurance', 'Disability Insurance', 'Income Protection', 'Salary Continuance', 'Trauma', 'Critical Illness', or be anything else where the insurance pays out if something happens to you as a person.

What is your partner's income from employment?

No employment income

$0 - $19,999

$20,000 - $49,999

$50,000 - $99,999

$100,000 - $149,999

$150,000 - $199,999

$200,000 - $250,000

Over $250,000

I prefer not to say

What other sources of income does your partner have?

Centrelink Pensions or Allowances

Investment income (such as dividends or distributions)

Rental property income

Non-government pension income (such as an Account Based Pension)

Business income

What is your partner's approximate total superannuation balance personally?

No superannuation based policies in my partner's name

$0 - $249,999

$250,000 - $499,999

$500,000 - $999,999

$1,000,000 - $1,999,999

$2,000,000 - $3,000,000

Over $3,000,000

I prefer not to say

Please list the names of any superannuation funds your partner has open.

Don't worry about checking their superannuation, If we know about the fund, we'll check there ourselves.

Please list and life insurance policies your partner has.

Anything else you would like us to know?

We like doing our homework. So, please tell us as much (or as little) as you like about yourself, what you're challenges are, ways you think we may be able to help, or anything else that we might like to know.

Finally, how did you hear about us?

If other, please provide details

Who referred you?

Recommendations from friends and colleagues are important to our business. Please let us know who referred you so we may pass on our thanks.

Who referred you?

In addition to allowing us to pass on our thanks, by reaching out to your professional adviser we can work together to ensure you get the best possible advice.

May we contact your professional adviser?

Yes, I give you permission to contact the professional adviser to request information about my situation.

Who referred you?

Recommendations from family are important to our business. Please let us know who referred you so we may pass on our thanks.

Relation to you