If you are scheduling an appointment to discuss Medicare plans or Individual Health Insurance plans, please complete the Scope of Appointment form. Centers for Medicare and Medicaid requires all licensed agents to obtain your permission prior to discussing plan information.
This is a consumer protection. By submitting this form, you are NOT obligated to enroll in any plan nor does this form enroll you in or change your coverage. This form simply allows you, the consumer, to decide what type of Medicare plans or Individual Health Insurance plan you would like to receive information on.
Please call (770)970-0312 if you have any questions.