Questionnaires and Checklists

If we have asked you to go to this page to download something then check here.

The following are documents that we need completed by new clients.   Please do as much as you can stand and either bring to our office or email to us.  We like to have these questionnaires completed so we are sure to have complete information for applications and documents.   Click on the links below and a browser window will open and you can print or download the file.   If you wish to fill it out online, go back to the previous screen and choose online Questionnaire.  This can be emailed directly from the link.

Phase I Form

Asset Protection Questionnaire – Married

Asset Protection Questionnaire

If we are preparing a Medical Assistance application for you , then you must start collecting the documents in the following list.  Just click the link and print it out.  Please read the last paragraph on page 2 for instructions.

Document Checklist – Nov 2014