(909) 627-5927 info@accty.com

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

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