Our Firm - Oak Crest Law Group, Los Angeles, CA Estate Planning & Wealth Strategies Law Firm

College Protection Plan

Consultation Request

Please complete and return this planning worksheet by clicking the SUBMIT button at the end. Upon receipt, we will contact you to schedule your consultation appointment. We request that you be as thorough as possible and look forward to seeing you!

Name(Required)

First Middle Last

Date of Birth:(Required)

MM slash DD slash YYYY

Are you a U.S. Citizen?(Required)

Yes

Email Address:(Required)

Phone Number:(Required)

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Do you have any disabilities, serious health problems, or other special needs?(Required)

Yes

If your answer was yes to the question above, please describe:

Financial Decision Makers (name, address, phone number, and relationship to you):(Required)

After you (and your spouse if applicable) have passed, who do you want making decisions regarding the management and distribution of your assets to your beneficiaries? PLEASE LIST THREE PERSONS IN THE ORDER THEY WOULD SERVE.

Health care decision makers (name, address, phone number, and relationship to you):(Required)

If you were unable to make decisions for yourself, who would you want to make decisions for you with regard to your medical treatment? PLEASE LIST THREE PERSONS IN THE ORDER THEY WOULD SERVE.

Do you want to provide that the moment of your death not be unnecessarily prolonged by artificial means or measures?(Required)

Yes

Do you want to provide that your vital organs be made available for transplant purposes?(Required)

Yes

Do you have the donor "pink dot" on your drivers license?(Required)

Yes

Today's Date(Required)

MM slash DD slash YYYY

Approval of Information Signature (input your full name):(Required)

By typing your full name, you hereby affirm that the above information and values are accurate to the best of your assessment.

Consent

I agree to the privacy policy.

Westlake Village

31355 Oak Crest Drive, Suite 125
Westlake Village, CA 91361

Los Angeles

One Wilshire Building
624 South Grand Avenue
Los Angeles, CA 90017

Northern California

490 Chadbourne Rd., 2nd Floor
Fairfield CA 94534

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