Forms (PDF)

Carlin & Shapiro client information form
If you have an appointment with us, or wish to make one, this form may be filled out before you arrive.

Release for financial information
A financial release that authorizes release of financial records and information to Carlin & Shapiro, P.A.

Release for medical information
A medical release that authorizes release of medical records and information to Carlin & Shapiro, P.A.

Release for Social Security Administration
A Social Security Release form that authorizes Social Security to release benefit information to Carlin & Shapiro, P.A

Release for the Department of Health and Human Services
A Department of Health and Human Services Release form that authorizes DHHS to release information on your behalf to Carlin & Shapiro, P.A.

List of documentation to provide for MaineCare application
A list of documents you will need to apply for MaineCare coverage under the long term care program.

MaineCare application for long term care
An application for long term nursing home benefits.

MaineCare application for community MaineCare
An application for community MaineCare benefits.

Application for Food Supplement, TANF, PaS, or MaineCare
An application for TAN, PaS, or MaineCare benefits.

Health Care Advanced Directive
A medical directive where you nominate health care agents, and make end of life decisions.

Social Security replacement card application
If you apply for MaineCare, and have lost your Social Security card, you may replace it by using this application provided by the Social Security Administration.