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How HSAs Work with
Medicare & Social Security
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1.
First Name
(Required.)
*
2.
Last Name
(Required.)
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3.
Phone Number
(Required.)
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4.
Email Address
(Required.)
5.
Spouse Name
*
6.
How did you hear about us?
(Required.)
Attended an Event
Email
Mail
Online Search (Google, Bing, Yahoo)
Podcast
Radio
Referral of a friend or family
Social Media
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7.
Please indicate your net investable assets:
(Required.)
Less than $250k
$250 - $500k
$500k - $1M
$1M - $3M
More than $3M
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8.
How close are you to retirement?
(Required.)
Less than a year
2-5 years
5-10 years
10-20 years
20+ years
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9.
Are you currently a Bradshaw client?
(Required.)
Yes
No
