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Client Questionnaire

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Food, Clothing and Misc.

Groceries
Groceries
Dining out
Laundry Supplies
Cleaning Supplies
Toilet Tissue
Paper Towels
Paper Napkins
Lawn & Garden Supplies
Postage
Stationery
Other (specify)
Other Amount
Clothing
Clothing
Laundry
Dry Cleaning
Shoes
Shoe Repair
Other (specify)
Other Amount
Personal Care
Hair Care Products
Haircuts
Beautician Services
Oral Hygiene Products
Shaving Products
Cosmetics
Perfume
Bath Preparations
Deodorants
Feminine Hygiene Products
Electric Personal Care Appliances
Nail & Personal care services
Other (specify)
Other Amount
Miscellaneous
Minimum payments on Credit Cards
Miscellaneous
Other (specify)
Other Amount
Total:
$0.00
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