Request Appointment

If you would like to request an appointment to meet with a local, licensed agent, in Oregon or SW Washington, please fill out as much information as possible and we will contact you within 24-48 business hours.

By submitting your information, a SeniorChoices NW agent may contact you by phone or email regarding your interest in Medicare Advantage, Prescription Drug, and/or Medicare Supplement plans.

Please also complete a Scope of Appointment Form so we can start the 48-hour required wait time required by Medicare to discuss plan information.