Fillable Scope of Appointment “SOA” Form

Click the green button below to review and e-sign our electronic Scope of Appointment form. Please note we are required by law to obtain this form before we can discuss Medicare Advantage and/or Prescription Drug Plans with you, and your signature must be dated at least 48 hours before our appointment. 

Also note that our client consent and privacy practice disclosure forms are a part of this document. Signing below will also acknowledge receipt of and agreement with those documents. Please note that in the world of Medicare, ‘beneficiary’ means YOU!