Medicare Consultation Form
Preparation form to complete before your Medicare consultation.
Forms
Download the forms you need for your Medicare consultation and enrollment, all in one place.
Medicare Forms
Scope of Appointment
Required form before a Medicare consultation.
CMS-40B: Application for Enrollment in Medicare Part B
Use this to sign up for Medicare Part B if you delayed it, for example while covered by an employer plan.
Official CMS form (OMB 0938-1230, expires 07/31/2028)
CMS-L564: Request for Employment Information
Confirms your employer coverage so Medicare can start Part B without a penalty.
Official CMS form (revised 03/2025). Your employer completes this when you enroll in Part B after leaving employer coverage.
Fill it in on your computer, save it, then upload it securely with the button above.
Questions about which forms you need? Call Craig at (339) 201-3044