Medicare Advantage, Medicare Prescription Drugs & Medicare Supplement Insurance Plans

Please download the "SCOPE OF APPOINTMENT" FORM

Once you have submitted  the"Permission to Contact" form, please now complete and approve the "SCOPE OF APPOINTMENT FORM , and  return it back to us via email or you may fax it to 

(203) 204-1958. This must be completed and received by us prior to our  appointment, as required by Federal and State Law.

2019 SCOPE OF APPOINTMENT FORM (pdf)

Download

If All Forms are Completed & submitted, call us for an appointment (203) 377-4311 or Book it Now!