Client Forms & Questionnaires

These forms help me better understand your needs and find you the most appropriate coverage. Many can now be filled out right in your browser—on any phone, tablet, or computer, with no PDF reader or app required. Take your time and complete them thoroughly—the more information you provide, the better I can serve your needs.

Fill Out Online

The easiest option—no downloads, no PDF reader. Just type your answers into the page on any device, then print or save a copy when you're done.

Retirement Checklist

Compare your benefits and income for the years ahead—health and dental coverage, life insurance, Medicare options, retirement accounts, and more. Works on any phone, tablet, or computer with no special software.

Fill In Your Browser

These forms open right in your web browser, where you can type your answers and then print or save them. No PDF reader app required.

Retirement Checklist (PDF)

The fillable PDF version of the retirement checklist, if you prefer a PDF to the online form above.

Scope of Appointment

A short Medicare form confirming which products we'll discuss at your appointment.

Retirement Income Fact Finder

Helps us map out your retirement income sources and goals in detail.

Health Questionnaire

A brief health questionnaire used when applying for certain coverage.

Print & Complete

These forms are best printed and filled out by hand. Open one in your browser to read it, then print and complete it before your appointment.

Long Term Care Questionnaire

Helps us understand your long-term care needs, health history, and coverage preferences.

Asset Location Form

A simple place to record where your important accounts and assets are held.

Where Do You Want Your Money to Go?

A worksheet to think through your wishes for your estate and beneficiaries.

How to Use These Forms

1. Open the Form

Use Fill Out Online or Open in Browser to complete a form on your phone, tablet, or computer—no PDF reader needed. Or choose a Print & Complete form to fill out by hand.

2. Complete Thoroughly

Take your time to answer all questions as completely and accurately as possible. The more information you provide, the better I can serve your needs.

3. Save or Print Your Copy

When you finish an online form, choose Print / Save as PDF to keep a copy. Then submit it by:

Forms ask for personal details, so please send them only through email, mail, or in person—not through the website—to keep your information private.

4. Follow Up

After reviewing your form, I'll contact you to discuss your options, answer questions, and provide personalized recommendations.

Additional Resources

Here are some helpful external resources for insurance and financial planning. These government websites and official sources provide valuable information to help you make informed decisions.

Covered California

Official California health insurance marketplace.

Medicare.gov

Official Medicare website with plan information and resources.

Social Security

Information about Social Security benefits and retirement planning.

Tax Forms

Access tax forms and resources for your financial planning needs.

Coaches

Find professional coaches for lifestyle and personal development.

Need Help?

If you have questions about any of these forms or need assistance completing them, don't hesitate to reach out. I'm here to help guide you through the process and ensure you get the coverage that's right for you.

Call or Text

(805) 528-4358

Office

2106 9th Street
Los Osos, CA 93402

Phone

(805) 528-4358

Fax: (805) 528-8140

Office

2106 9th Street
Los Osos, CA 93402
CA License #0E26264
Monday-Thursday: 9:00 AM - 3:00 PM