Planning Wizard - Form - Senior Care Counsel

Ready for your results?

Now that you've provided some details about your situation, we'll be able to connect you with the right professional.

Fill out your contact information below to see your results and learn more about how we can help.

What's included in your results?

Based on the details you provided, we'll present some insight to help you better understand the potential solutions available to help you achieve financial relief from long-term care.

Your results include:

The estimated savings for your situation
An overview of our educational resources
A recommended planner to guide you through long-term care planning

Who Needs a Plan?

Is this person currently receiving care?

Your First Name

Your Last Name

Your Email Address

Your Phone Number

Your State

Your Loved One's Name

The Applicant's Marital Status

What is the estimated total value of your assets?

You may exclude the value of your home and one vehicle.

Exclude value of your home and one vehicle (unless you plan to sell your home before receiving care). Include spouses assets if married

What is your estimated monthly income?

Include Social Security, pension income, Required Minimum Distributions, and any other monthly income of the individual needing care.

I understand that by contacting a lawyer, or law firm through Senior Care Counsel, I will not create an attorney-client relationship and the message will not necessarily be treated as privileged or confidential.