Health Insurance - Prepare for your Appointment

Medicare

Intake Form

Complete this fillable form and return to us prior to your appointment. You are providing us with the essential information to make sure we match you with a plan that works for your needs!

Medicare Intake Form

Scope of Appointment

This form is required by Medicare and needs to be completed annually before we can discuss Medicare Plans and Products. Think of it as a permission slip.

Scope of Appointment Form

Medicare Disclaimer: Currently we represent 8 organizations which offer 52-61 products in your area. You can always contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) for help with plan choices.