Southmselderlaw

Registration Info

Welcome to the Mayhone Elder Law Adult Incapacity Plan! Here are a few tips before you begin:

1. Do not overthink this! These questions are designed to get you thinking. All answers will be reviewed with a qualified and licensed attorney and can be changed.

2. This is designed to be quick and easy! Typically taking people about 15-20 minutes to complete.

3. You can revisit the site if you need to make changes or updates at any time (just use the username and password you created).

4. After you are satisfied with your answers, you will click to submit them. You will then be directed to pay for your plan.

5. Once completed and paid, our attorney will review them and prepare them for signing.

First Name *

Middle Name

Last Name *

Email *

Password *

Cell *

Your Contact Details

Name:

Date Of Birth *

Also known as(optional)

Are you married? *

✓

Yes

✓

No

Suffix(optional)

✓

Jr

✓

Sr

✓

II

✓

III

✓

Other

Gender

✓

Male

✓

Female

Your Address

Full Address: *

State *

NOTE: It is assumed that you will leave your estate to your spouse/domestic partner if she/he survives you.

Your Spouse Information

Your spouse's Details

First Name: *

Middle Name

Last Name: *

Email *

Date Of Birth *

Cell *

Suffix(optional)

✓

Jr

✓

Sr

✓

II

✓

III

✓

Other

Also known as(optional)

Gender

✓

Male

✓

Female

Is Your spouse's address different than you? *

✓

Yes

✓

No

State: *

Power of Attorney

Provide the information of one or more individuals who will serve as your agent under the Durable Power of Attorney:

Primary Agent: *

Phone Number: *

Address : *

Alternative Agent: * Click the "+" button to add another agent

Phone Number: *

Address: *

Power of Attorney-Spouse/Partner

Primary Agent: * Click the "+" button to add another individual.

Phone Number *

Address *

Health Care Power of Attorney

Please provide the information of one or more individuals who will serve as your health care agent:

Do you wish to use the same agents as your Power of Attorney? *

✓

Yes

✓

No

Primary Agent: * Click the "+" button to add another individual.

Would you like to be an organ donor?

✓

Yes﹐for transplantation purposes only

✓

Yes﹐for transplantation﹐education and/or research

✓

No

Health Care Power of Attorney Spouse/Partner

Provide health care agent to make medical conditions on your behalf

Please provide the information of one or more individuals who will serve as your health care agent:

Do you wish to use the same agents as your Power of Attorney? *

✓

Yes

✓

No

Primary Agent: * Click the "+" button to add another individual.

Would you like to be an organ donor?

✓

Yes﹐for transplantation purposes only

✓

Yes﹐for transplantation﹐education and/or research

✓

No

Submission Screen

If you would like to review your responses, you can select each screen and review your answer or select the previous button which will open a print screen page. Click the “Submit” button below to be directed to a page where you will be able to pay for your estate planning documents you selected. Once you have paid for your documents, your information will be sent to our office, and you will then be prompted to schedule a phone call or Zoom meeting to review your documents with a legal professional.

Preview Answers

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