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About You....

 First of all, I am glad you are here!

And recognize that your being here is thanks to your understanding the possibility of needing Long Term Care some day.
And that this possibility requires planning, not only to protect assets, but to ensure the type and quality of care that
is what will make you or your loved ones most comfortable.

Congratulations for doing this today, as you will never be younger. And your health today may be better than in the future. 

I do understand the thought process that has brought you here, and know that the last thing you need is pressure! 

At this site you may proceed at your own pace; I will be here each step along the way to offer a helping hand.

 If you let me know a little about yourself, it will be easier for me to make sure that you are looking at all the alternatives that should be considered in YOUR Long Term Care plan.

Please fill out the following information:
Name
State of primary residence
Date of Birth
Sex Male Female
Marital Status
Height
Weight
Major health conditions
Name of spouse
Date of birth of spouse
Major Health conditions
of spouse
Height
Weight
Assets other than primary residence under $100K $100K - $250K $250 - $500K $500K- $1M
Are you interested in ways to: Insure Self Insure Combination
 Plans  in place or
 under consideration
Special Questions 



Copyright © 2006 Long Term Care for Smarties. All rights reserved.
Revised: 01/13/08

 

 

 

 



Copyright © 2006[Long Term Care for Smarties]. All rights reserved.
Revised: 01/13/08