Before we meet

What to bring to your appointment

Six things that make the first conversation useful, on one printable page with room to write. Bring whichever apply to you — none are required to talk.

Before your appointment

A little preparation.
Room for your questions.

Keep the checklist nearby as you gather the items that apply to your appointment.

View the checklist ↓

One page. Space to write.
Prepared for US Letter and A4, in black on white.

Use 100% scale and turn off browser headers and footers in the print dialog. Only the checklist prints; you can mark the boxes on screen or by hand. Nothing is submitted or stored.

Appointment checklist

What to bring

Bring the items that apply to your appointment.

DoctorPractice / location
 
 
 
PrescriptionDosage
 
 
 
 

For claiming questions.

For auto, home or business insurance.

Questions I want to ask

NY licenses: LA-1934647 · PC-1934647 · BR-1934647

Use the back of this sheet if you need more room.

Ready when you are

Bring what you have. If something is missing, we'll work around it.

Quick replyUsually within 30 minutes during office hours

How should I reach you?

By submitting, you agree that Ibrahim Afyon, a New York–licensed insurance agent and broker, may call or email you about this request, even if your number is on a Do Not Call list. Texts only if you choose Text above; message frequency varies and message and data rates may apply. Reply STOP to opt out, HELP for help. Consent isn't a condition of purchase and you can withdraw it any time. This isn't a Medicare Scope of Appointment. Medicare Advantage and Part D calls are recorded. Privacy policy.