Contact Signature Advantage Plan Want to speak with a Signature Advantage (HMO ISNP) Representative? Yes! I would like to discuss Signature Advantage’s Medicare Advantage Prescription Drug Benefit Institutional Special Needs Plan with a Signature Advantage Representative. You have my permission to contact me as listed below.Facility Name(Required) Are you a resident or an authorized representative for someone?(Required) Resident Authorized Representative Name of Resident(Required) First Last Phone Number(Required)Name of Authorized Resident Representative(Required)(If applicable.) First Last Relationship to Resident(Required) Phone Number of Authorized Representative(Required)Preferred Method of Contact(Required) Phone Call Schedule Personal Appointment When is the best time to call?(Required) Hours : Minutes AM PM AM/PM (Time is in EST.)Preferred Date(Required) Month Day Year Preferred Time(Required) Hours : Minutes AM PM AM/PM (Time is in EST.) By signing and returning this reply card, you are agreeing to a meeting with a Signature Advantage Representative to discuss the Signature Advantage Plan. Signing this form does not obligate you to enroll in the plan, automatically enroll you in the plan or affect your current or future Medicare enrollment status.Beneficiary or Authorized Representative Signature(Required) Today's Date(Required) MM slash DD slash YYYY