Legacy Scope of Appointment

The Scope of Appointment is a federally required form used to document an appointment between an insurance agent and a Medicare beneficiary to ensure that no other types of products are discussed outside of what the beneficiary originally requested. Your completion of a Scope of Appointment does not require, imply or suggest that you intend to purchase a Medicare plan from an insurance agent. The form protects the beneficiary from being solicited for a product that he/she did not originally express interest.

Please CLICK HERE to download a printable Scope of Appointment Form.

Bring the completed form to your appointment, e-mail it to info@LBConline.biz or fax to 952.657.7523.