July 11, 2026

Elder Law & Medicaid Planning Intake Forms: What Every Field Should Capture

Most people who call an elder law attorney are already stressed. Maybe Dad fell last month, the rehab facility is asking about long-term placement, and the family just found out that a semi-private room runs $12,000 a month. Or maybe Mom is still doing fine at home, but she is 82 and the family wants to plan while there is still time. Either way, the first meeting needs to count. And the only way it counts is if you have the right information before the consultation starts.

That is where the intake form does its work. Not a generic client information sheet with a name, phone number, and a blank notes field. A real elder law and Medicaid planning intake form — one that captures the financial, medical, family, and legal details an attorney actually needs to give useful advice on day one. Here is what that form should include and why each section matters.

Client demographics and living situation

Start with the basics, but go further than most intake forms bother. You need the client's full legal name, date of birth, Social Security number, marital status, and current address. But you also need to know where they are living right now. Their legal address might be a house they owned for forty years, but they might be in a rehab facility, an assisted living community, or staying with an adult child after a hospital discharge. The answer shapes everything: whether the home is a countable asset, whether a community spouse resource allowance applies, and how urgent the Medicaid timeline really is.

Capture citizenship and residency state as well. Medicaid is a state-administered program, and the eligibility rules in New Jersey are different from the rules in Florida or New York. A client who just moved to be closer to family may have residency complications that affect which state's program they apply to.

Family members involved in care

Elder law matters almost never involve just one person. An adult daughter is usually the one making the phone call. A son might be handling the finances. The spouse may be the "community spouse" who needs protection from impoverishment while the other spouse applies for Medicaid. Your form needs to map this:

• Spouse name, date of birth, health status, and whether they are the applicant or the community spouse.
• Children — names, ages, locations, and role in the client's care. A child who has lived in the home for two or more years providing care that delayed institutionalization may qualify for a home transfer exemption under Medicaid rules. You cannot identify that if you do not know who lives where.
• Other family members or non-family caregivers involved in decision-making or daily care.
• Who is the primary contact for this matter? Who has authority to act, and under what document (power of attorney, guardianship order, etc.)?

Current health conditions and care needs

You are not the client's doctor, but you need enough medical context to plan. What are the primary diagnoses? Is the client dealing with dementia, Alzheimer's, Parkinson's, a stroke recovery, COPD, cancer? Is the condition stable or progressive? A progressive cognitive decline means the window for executing legal documents is closing — and that changes your timeline for getting a power of attorney, healthcare proxy, and trust in place.

What level of care does the client currently receive? Independent at home, home health aides, assisted living, skilled nursing? Has a physician assessed the client's cognitive capacity? These are not medical questions — they are legal planning questions, because the answers determine what documents can still be signed, whether a guardianship petition is needed, and what Medicaid category the client falls into.

Income sources and the asset inventory

This is the section where many generic forms fall short. Medicaid eligibility is a financial determination, and it is precise. Your intake needs to capture every income stream: Social Security benefits, pension payments, annuity distributions, rental income, investment dividends, VA benefits. For a married couple, you need both spouses' income because the income allocation rules for community spouses vary by state.

Then the assets. The home — current value, mortgage balance, whose name is on the deed. Vehicles. Bank accounts (checking, savings, CDs). Investment and brokerage accounts. Retirement accounts (IRAs, 401(k)s — note that in some states, certain retirement accounts are exempt). Life insurance policies with cash surrender value. Burial trusts or prepaid funeral plans. Real property other than the primary residence. Business interests.

If this sounds like a lot of financial detail for a first meeting, that is because Medicaid eligibility turns on exactly this information. You cannot tell a family whether Dad qualifies for Medicaid, whether a spend-down is needed, or how to protect the house without knowing what the financial picture looks like. A form that captures this upfront means you can actually analyze the situation before the consultation instead of spending the first hour asking for account balances.

Gifting history and the lookback period

Medicaid imposes a five-year lookback period (in most states) on asset transfers. Any gift, transfer for less than fair market value, or shift of assets during that window can trigger a penalty period — months during which Medicaid will not pay for nursing home care even though the applicant otherwise qualifies. Your intake form needs to ask directly: has the client given money or property to anyone in the last five years? Added a child's name to a bank account or deed? Transferred a vehicle? Made large charitable donations?

Families do not always think of these as "transfers." Grandma gave $20,000 to a grandchild for a wedding. Dad added his daughter to the house deed three years ago "so it would be easier." These are exactly the transactions Medicaid will flag. If your intake form does not ask about them, you will not learn about them until the Medicaid caseworker sends a denial letter.

Existing estate planning documents

Before you draft anything new, you need to know what already exists. Does the client have a will? A revocable living trust? An irrevocable trust? A durable power of attorney? A healthcare proxy or living will? When were these documents executed, who drafted them, and — critically — are they still valid given the client's current capacity? An estate planning intake form covers much of this ground, but in the elder law context these documents take on added urgency because a client with declining capacity may not be able to execute new documents much longer.

Medicaid application status and long-term care details

Some clients come to you before applying for Medicaid. Others come after a denial. Your form should capture where the client stands: has an application been filed? If so, when, with which agency, and what was the result? Is there a pending appeal? Has the client already been receiving Medicaid community benefits and now needs to transition to institutional coverage?

If the client is in a long-term care facility, capture the facility name, admission date, current monthly cost, and whether the client is currently private-pay or has another payment arrangement. This information tells you how much financial runway the family has before assets are depleted and Medicaid becomes urgent rather than optional.

VA benefits, guardianship, and other factors

If the client or their spouse is a veteran, VA Aid and Attendance benefits may supplement Medicaid or provide an alternative source of long-term care funding. Your intake needs a simple yes/no on veteran status, branch of service, and discharge status. Similarly, probate and estate matters intersect with elder law when a client dies during the planning process or when guardianship becomes necessary.

Speaking of guardianship: if the client lacks capacity and no power of attorney exists, guardianship or conservatorship may be the only path forward. Your intake form should flag whether any guardianship proceeding is pending, has been filed, or is anticipated. This changes the engagement entirely — you may be representing the proposed guardian, not the incapacitated person directly.

Why a purpose-built form matters

Elder law sits at a crossroads of healthcare, benefits law, estate planning, tax, and family dynamics. A generic legal intake form will capture the client's name and contact information. It will not capture the lookback period transfers, the community spouse resource question, the VA eligibility, or the existing trust that might disqualify the client from Medicaid. Every one of those gaps means another follow-up call, another delayed consultation, another family left waiting for answers.

A form built specifically for this practice area gets that information on your desk before the first meeting. That is the difference between a productive consultation and one where you spend the whole hour asking questions you should have already had the answers to.