Engagement Letter
This letter presents your engagement with Susan Polk Insurance, including a disclaimer and waiver regarding electronic data transfers.
Return completed form by fax to 805-544-8096 or by email to info@susanpolk.com.
Scope of Appointment Form
Please fill out this form to advise us as to which Medicare plans you would like an agent to discuss with you.
Return completed form by fax to 805-544-8096 or by email to info@susanpolk.com.
Prescription Drug Form
To recommend a prescription drug program for you, please tell us which prescription drugs you are currently taking.
Return completed form by fax to 805-544-8096 or by email to info@susanpolk.com.