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Real Evaluation from Rick West

This evaluation only takes 2 Minutes. You Get REAL answers from a REAL Specialist - More people trust Rick than any other attorney.

1. Your Problems: (check all that apply) *This question is required.

Credit Card
House Payments
Medical Bills
Payday Loans
Auto Payments
Tax Debt
Student Loans
Other problem Please enter an 'other' value for this selection.

2. What caused your problem? (check all that apply) *This question is required.

Loss of job
Health problems
Divorce
Other Please enter an 'other' value for this selection.

3. What collection problems do you now have? (check all that apply)

Garnishment of wages/bank account
Lawsuits, actual or threatened
Threats by mail
Telephone calls from bill collectors
None yet - I'm just concerned at this point
Other (please tell me) Please enter an 'other' value for this selection.

4. What is your average "take-home" pay each paycheck? This question requires a valid number format.

5. How often are you paid?

6. What is your marital status?

7. If married or live with significant other, how much do they contribute to the household income?

8. What's your biggest fear about your finances?

9. How ready are you to fix your problems? *This question is required.

10. What options have you considered?

None yet - I am just getting started.
Credit Counseling
Debt Management Program
Debt consolidation loan
Using my retirement account
Borrowing from family/friends
Chapter 7
Chapter 13
Other Please enter an 'other' value for this selection.

11. In a perfect world, if you could have me do anything for you - what you you want me to do? What change in your life would you want me to make happen? *This question is required.

12. Please share your first name: *This question is required.

13. Your email address: (don't worry, we never share it) *This question is required. This question requires a valid email address.

14. Your zip code: *This question is required. This question requires a valid number format.

15. Your Phone #

Never enter passwords or other sensitive information on this form. Report Abuse

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