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Get Sales Appointment Confirmation 2017-2024

Eeting when possible, to ensure understanding of what will be discussed between the sales agent and the Medicare beneficiary (or their authorized representative). All information provided on this form is confidential and should be completed by each person with Medicare or his/her authorized representative. To be completed by the Beneficiary or Authorized Representative Check the product type(s) you want the agent to discuss (required): (refer to page 3 for product type descriptions) â–  Standal.

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