SCOPE OF APPOINTMENT CONFIRMATION

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The Centers for Medicare and Medicaid Services (CMS) regulations for Medicare Communications and Marketing Guidelines require that all sales agents document the scope of any marketing/sales appointment prior to any face-to-face, telephonic, or virtual sales meeting to ensure that both the Medicare Beneficiary (or his/her Authorized Representative) and agent understand what topics are to be discussed. 

Please complete the fillable .pdf document below and then return to us through our secure email system by clicking the link in your appointment confirmation email, or by using the button below.

Failure to return this completed form within 48-hours PRIOR to your scheduled appointment will require that your appointment be rescheduled.