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Scope of Sales Appointment Confirmation Form To be completed by person with Medicare. Please initial below in the box beside the plan type you want the agent to discuss with you. If you do not want
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Who needs do not want form?

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Individuals who no longer wish to receive a particular item or service.
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The 'do not want form' is a document used to indicate that an individual does not wish to participate or receive certain services or information.
Any individual who wants to opt out or decline participation in a specific activity or service may be required to file a 'do not want form'.
The 'do not want form' can typically be filled out by providing personal information and checking off the boxes indicating the services or activities the individual does not wish to participate in.
The purpose of the 'do not want form' is to give individuals the opportunity to decline or opt out of certain services or activities.
The 'do not want form' typically requires personal information such as name, contact details, and specific services or activities the individual wishes to opt out of.
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