Scope of Appointment

This document allows me to discuss various Medicare products with you. When you click on the button below the instructions, it will open up the Scope of Appointment page in a new tab. This will allow you to toggle back and forth between the instructions and filling out the Scope of Appointment. 

INSTRUCTIONS:

• Click in the box next to I am not a robot. This will take you to the SoA page.
• Please indicate the type of product(s) you want the agent to discuss:  If unsure, leave all four checked, otherwise, check your preference(s).  
• Beneficiary Details: You are the beneficiary. Fill in the boxes accordingly.
• Meeting Preferences: It does not matter what you put in here. (Please note that if you have not previously discussed an appointment time/date, putting it in those fields does not create an appointment. You must reach out to an Aaron Flake Health Agency representative to make an appointment.) 
• Beneficiary/Authorized Representative Signature and Signature Date: Sign with your mouse or finger.
• Click the yellow submit & download button.