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The following information is for people who got a Notice of Overpayment from the Social Security Administration (SSA).
The information is from a website called Learn the Law.org that is information put together by Statewide Legal Services, CTLawHelp.org and Center for Computer-Assisted Learning (CALI) to help people with common legal aid problems.
This form may be signed prior to a hospitalization to make clear your wishes in certain health care situations. A copy should be provided to the hospital, at admission. You may also wish to provide one to your primary doctor.
The form, attached below, is fillable.
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