Scope of Appointment

The Scope of Appointment is required by the Centers for Medicare and Medicaid Services (CMS) to be completed by every Medicare Beneficiary providing me with your written permission to talk to you about Medicare Advantage, Prescription drug plans, ancillary products such as Dental, Vision, Hearing and other Indemnity products.

I must have this document before I can engage in discussions with all future clients.  All the Beneficiary needs to do is put his/her initials in all the boxes on the first page and then sign and date the second page by Beneficiary Signature and send it back to me via email to: rene@casanovains.com.

Scope of Appointment Form