Appointment Worksheet

Appointment Worksheet

Congratulations on taking the first step to getting answers to questions regarding your personal financial situation. At Consumer Credit Counseling Service, we strive to give the best possible advice to the people that seek our assistance. To do that, we need to have you come prepared for your appointment with your counselor, and that preparation will require some work on your behalf.

The worksheet we ask you to fill out is not meant to be overwhelming, but it does require some time to complete. There are roughly four sections; Contact/Employment information, Assets, Monthly Household Expenses, and Debt. It may help you to break up this task into sections, and not try to do it in one sitting. We really need the information to offer the best possible options.

In addition, please read and sign the Privacy Statement, and the Statement of Counseling Services. These forms need to be completed before your appointment. We have placed them on-line so that your appointment time in the office is not taken up completing paperwork, but spent reviewing your situation with your counselor. 
So please complete the worksheet, and review the privacy statement and counseling statement
prior to your appointment.

To print the worksheet, click here. The worksheet is designed so that you can open the file, and type directly into the form. You will not be able to "save" the information, so once the worksheet is complete, you will need to print the worksheet to bring to the office for your appointment.We cannot retrieve this worksheet from the website. You must print it!  If you wish, you may just print the blank form and fill in the form by hand. To print the Privacy & Counseling Services Statements, click here.

If you have multiple employers, you will need to print this page. 
You may need additional pages of the creditor page and that page is available here. 

You must have the Adobe Acrobat Reader properly installed to view these files. It is available for free from the Adobe website.

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About Us
Debt Management Plan


820 Crater Lake Ave Suite 202
Medford, OR 97504
Phone: 541-779-2273
Fax: 541-779-6412
Hours: 8:00am - 12:30pm & 1:30pm - 5:00pm