QMB Application Form

[Chris]

There is a new QMB application in the 'files section' of the Medicare
Savings Coalition website that you can type information into and print
up for submission (it cannot be emailed in). I hope it is helpful,
and may reduce errors or problems caused by IMA staff not being able
to read handwriting.

Let me know if you have any trouble with it and we can make changes.

Best,
Chris DeYoung