Survey

The Affordable Care Act (Obamacare) will affect you in big ways, whether you know it or not! But its impact will vary depending on your situation.

Tell us which categories you fall into, and we can help you plan.

Do you currently have health insurance coverage?
YesNo

Is your health coverage provided by your employer?
YesNoNot Applicable

Is your coverage provided by your spouse's employer?
YesNoNot Applicable

Are you purchasing your own health coverage independently?
YesNoNot Applicable

Does your health plan cover your whole family, or just you?
YesNoNot Applicable

Do you receive health coverage through Medicaid?
YesNoNot Applicable

We strive to be prompt and proactive in meeting your needs. Here are some questions that will help us do that:

After your tax appointment, how soon would you prefer to receive your completed return?

0-5 days6-12 days12-30 days

Would you like to schedule a planning appointment before the end of the year? (We recommend it!)

YesNo

Your information

Name

required

required

Company

required

Title

Location

required

required

Phone
-- required

Email address

required