[Name], please fill in the form below

All fields are required (except MI), we will have your Plan to you in two business days.

General Information

Student

First Name

Last Name

Student's Address

Street

City

State (must be WI)

Zip Code (5-digit)

Mother

First Name

Last Name

Father

First Name

Last Name

Student's Date of Birth (MM/DD/YYYY)

College Attending

Expected Graduation Date (MM/YYYY)

Student's Email Address

Are you married, in a domestic partnership, or planning either within the next year?

Do you currently have a child or expect one in the coming year?

HIPAA Authorization

This document lets your parents access your medical records and talk to doctors about your care immediately.

Choose the parent who you want to have this authorization.

Choose which parent should be listed first:

Healthcare Power of Attorney

This document lets your parents make medical decisions when you can't make them yourself.

Choose the parent who handles medical decisions better.

Choose which parent should be listed first:

Financial Power of Attorney

This document allows your parents to help or handle your financial, student, and digital affairs

Choose the parent who you want to help you with your current medical care.

Choose which parent should be listed first:

Last Will and Testament

This document ensures your property goes to your parents and they can handle your affairs if the unthinkable happens

Choose the parent who you in charge of your estate.

Choose which parent should be listed first:

WARNING: If you do not trust your parents or do not want them to have these powers, this product is not appropriate for you. You should stop and not go further.

Thank you! We will start working on your plan and send it to you in the next two business days.

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Welcome to the final step!

[Name], please fill in the form below

General Information

Student's Address

HIPAA Authorization

Healthcare Power of Attorney

Financial Power of Attorney

Last Will and Testament

WARNING: If you do not trust your parents or do not want them to have these powers, this product is not appropriate for you. You should stop and not go further.