Name* First Last Email* Phone*Provide the name of your Portfolio Medics representative (if you do not have one, please type "None")* 1. I plan to begin taking money from my investments in…*A. 1 year or lessB. 1-2 yearsC. 3-5 yearsD. 6-10 yearsE. 11-15 yearsF. More than 15 years2. As I withdraw money from these investments, I plan to spend it over a period of…*A. 2 years or lessB. 3-5 yearsC. 6-10 yearsD. 11-15 yearsE. More than 15 years3. When making a long-term investment, I plan to keep the money invested for…*A. 1-2 yearsB. 3-4 yearsC. 5-6 yearsD. 7-8 yearsE. More than 8 years4. From September 2008 through November 2008, stocks lost more than 31% of their value. If I owned a stock investment that lost about 31% of its value in three months, I would… (If you owned stocks during this period, please select the answer that matches your actions at that time.)*A. Sell all of the remaining investmentB. Sell some of the remaining investmentC. Hold on to the investment and sell nothingD. Buy more of the investment5. Generally, I prefer an investment with little or no ups or downs in value, and I am willing to accept the lower returns these investments may make.*A. I strongly disagreeB. I disagreeC. I somewhat agreeD. I agreeE. I strongly agree6. When the market goes down, I tend to sell some of my riskier investments and put the money in safer investments.*A. I strongly disagreeB. I disagreeC. I somewhat agreeD. I agreeE. I strongly agree7. Based only on a brief conversation with a friend, coworker, or relative, I would invest in a mutual fund, stock or other investment.*A. I strongly disagreeB. I disagreeC. I somewhat agreeD. I agreeE. I strongly agree8. From September 2008 through October 2008, bonds lost nearly 4% of their value. If I owned a bond investment that lost almost 4% of its value in two months, I would… (If you owned bonds during this period, please select the answer that matches your actions at that time.)*A. Sell all of the remaining investmentB. Sell some of the remaining investmentC. Hold on to the investment and sell nothingD. Buy more of the investment9. The chart below shows the highest one-year loss and one-year gain on three different hypothetical investments of $10,000. Given the potential gain or loss in any one year, I would invest my money in…*A. Investment AB. Investment BC. Investment C10. My current and future income sources (such as salary, Social Security, pension) are…*A. Very unstableB. UnstableC. Somewhat stableD. StableE. Very stable11. When it comes to investing in stock or bond mutual funds (or individual stocks or bonds), I would describe myself as…*A. Very inexperiencedB. Somewhat inexperiencedC. Somewhat experiencedD. ExperiencedE. Very experiencedNameThis field is for validation purposes and should be left unchanged.