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If you would like to learn more about our wealth management services and have a net worth of $1,000,000 (excluding the value of your home), and/or anticipate having at least $500,000 to invest within the next three years, please complete the following survey. We will send you a free copy of Financial Focus, D. L. Blain & Co.’s newsletter.

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1. Is your primary source of income adequate, predictable and steadily growing?
Yes No

2. Do you have prior experience with stocks, bonds and international investments?
Yes No

3. On a scale of 1 to 10 - with 1 being most conservative and 10 being most aggressive - how would rate yourself as an investor?
1 2 3 4 5 6 7 8 9 10

4. Would you be comfortable giving your advisor full discretion in managing your investable assets?
Yes No

5. Would you be comfortable referring your advisor to a family member or friend?
Yes No

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