Planning for Your Upcoming Appointment

The forms below must be completed and returned to Slonim Law before the day of your appointment. Failure to do so will result in your appointment being rescheduled.

Appointment of a Designated Representative

DOWNLOAD FORM

Document Checklist

DOWNLOAD FORM

Financial Information Release

DOWNLOAD FORM

Florida ICP Medicaid Fact Sheet

DOWNLOAD FORM

Informed Consent

DOWNLOAD FORM

Intake Form

DOWNLOAD FORM

PSK Intake

DOWNLOAD FORM

QIT Intake

DOWNLOAD FORM

Information and Items needed for Medicaid Planning

  • Identification (License, SS card, Birth Certificate, Medicare Card)
  • Current banking and securities statements (to estimate assets such as checking/savings, annuities, IRAs, etc.)
  • List of incomes (retirement, pension, SS, etc.)
  • Most recent Social Security award letter
  • Current bill statements for property taxes, mortgage, HOA fees
  • DD-214 discharge papers (VA only)
  • Physician information for the applicant
  • Estate documents