| General information | Yes | No | N/A |
| 1. Has relevant personal information been gathered? | |||
| 2. Marital status? Time frame for starting a family | |||
| 3. Has financial situation been assessed? Income Expenses Assets Debts and liabilities Insurance information Employee benefits available | |||
| Notes: | |||
| Money management | Yes | No | N/A |
| 1. Have financial goals been determined or revised? Short-term goals Intermediate-term goals Long-term goals | |||
| 2. Has budget been updated to reflect changes in income and expenses? Housing costs Transportation costs Food, clothing, and other household expenses Health-care expenses Life and disability insurance premiums Adoption costs Child-care costs Temporary or permanent reduction in income if parent chooses to stay with child rather than work outside the home | |||
| 3. Has an emergency reserve account equal to at least three to six months’ worth of living expenses been set aside? | |||
| Notes: | |||
| Insurance planning | Yes | No | N/A |
| 1. Has need for life insurance been evaluated? | |||
| 2. Have beneficiary choices been updated? | |||
| 3. Has the need for disability insurance been evaluated? | |||
| 4. Is health insurance coverage adequate? Maternity costs Labor and delivery costs Changes to health-care providers Health-care expenses, including premium costs, co-payments, coinsurance, coordination of benefits, and deductibles Other employer-sponsored health plan options (if family coverage under other plan is better or more cost effective) COBRA benefits if job loss is anticipated | |||
| Notes: | |||
| Estate planning issues | Yes | No | N/A |
| 1. Have valid wills been executed or updated? | |||
| 2. Durable power of attorney or health-care proxy? | |||
| 3. Has guardian for child been chosen? | |||
| 4. Have other estate planning strategies been discussed? Use of trusts Gifting assets | |||
| Notes: | |||
| Education planning | Yes | No | N/A |
| 1. Has need to start saving for college early been discussed? | |||
| 2. Have college savings options been outlined or considered? Coverdell education savings accounts Series EE bonds Custodial accounts Section 529 plans Other savings/investment options | |||
| Notes: | |||
| Retirement planning | Yes | No | N/A |
| 1. Have ways to resolve competing needs to save for retirement and a child’s education been discussed? | |||
| Notes: | |||
| Tax planning | Yes | No | N/A |
| 1. Have changes to federal and state income tax situation been discussed? Additional exemptions Child tax credit Child and dependent care credit Adoption credit Use of flexible spending accounts | |||
| 2. If child has already been born, has Social Security number been obtained? | |||
| Notes: | |||
| Other | Yes | No | N/A |
| 1. Has eligibility for unpaid leave under the Family and Medical Leave Act of 1993 been determined? | |||
| 2. Is paid leave available through state or employer (short-term disability benefits or other benefits)? | |||
| 3. Have child-care options been discussed? | |||
| 4. Adoption issues? Are adoption benefits through employer available? | |||
| Notes: | |||
Prepared by Broadridge Advisor Solutions. © 2026 Broadridge Financial Services, Inc.

