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Questionnaires

Please ensure the comprehensive questionnaire attached is completed prior to arriving to your consultation appointment. Please do not leave any questions blank. If a question or section is not applicable, please write N/A next to the question or section.

Because the Department of Children and Families (Medicaid) and the Veteran’s Administration for Aid & Attendance have strict rules (federal laws) that determine whether an applicant qualifies for benefits, we request detailed information in order for the attorney to assess the situation and make recommendations regarding the applicant’s eligibility.

The information (your assets, income, and out-of-pocket medical expenses) you share with us remains confidential and protected under the attorney-client privilege and will not be disclosed to anyone without your authorization.

We look forward to meeting you.