Welcome To Lexaguard Digital Intake
Get started, provide your information below and provide your Child's info on the next page

Have you met with our office before? *
✓
Yes
✓
No
Applicant Information
Are you filling this out for yourself or for your loved one? *
✓
For a Loved One
✓
For Myself
Do you have any health issues? *
✓
Yes
✓
No
Are you/the applicant currently in a rehab, hospital or nursing home? *
✓
Yes
✓
No

General Information
Are you/the applicant a veteran? *
✓
Yes
✓
No
Do you/the applicant have any estate planning documents (Will, POAs, Trusts)?
✓
Yes
✓
No
Do you/the applicant have any children? *
✓
Yes
✓
No
Information
Applicant Information
*

*

*

*

*

*

Is the applicant married? *
✓
Yes
✓
No
Suffix(optional)
✓
Jr
✓
Sr
✓
II
✓
III
✓
Other
What are your personal pronouns?
✓
he/him
✓
she/her
✓
they/them
*

Is Your mailing address the same as your home address? *
✓
Yes
✓
No
Total Estate Size
*
Real Estate
Do you/the applicant own a home?
✓
Yes
✓
No
Assets Information
Do you/the applicant own any checking or savings accounts? *
✓
Yes
✓
No
Do you/the applicant own any retirement accounts? *
✓
Yes
✓
No
Do you/the applicant have any outstanding debt besides a mortgage? *
✓
Yes
✓
No
Assets Information Continued
Do you/the applicant own any investment or non-retirement accounts? *
✓
Yes
✓
No
Do you/the applicant own a business? *
✓
Yes
✓
No
Do you/the applicant own any life insurance policies? *
✓
Yes
✓
No
Do you work with a financial advisor? *
✓
Yes
✓
No
Do you have any additional information to share or comments that would be helpful to know about your assets? *
✓
Yes
✓
No
Monthly Income
Please add your/the applicant’s income information for any applicable sources.

Currently Employed?
✓
Yes
✓
No

Is your spouse currently Employed?
✓
Yes
✓
No
Additional Information

Referral Information
How did you learn about Beacon Legacy Group?
*

Summary
If you would like to review your responses, please review your responses on the right hand side on the specific screens. After you click submit, you will be finished and we will email your answer and the office will contact you with the next steps .
Preview Answer
Your Progress

0% Complete

Welcome To Lexaguard Digital Intake Applicant Information General Information Information Total Estate Size Real Estate Assets Information Assets Information Continued Monthly Income Additional Information Referral Information Summary