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Important Forms & Documents
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contract_signing-175x153Council on Aging Code of Conduct - The Swansea Council on Aging has adopted a "Code of Conduct" that outlines the requirements we all must meet at the center.  This Code was created to protect all who frequent the center or use COA programs/services and for the benefit and well-being of everyone, it must be adhered to at all times.  Safety, dignity and respect are always a must at your center.

i_agree-175x117Council on Aging Participation Agreement - All of the programs and services provided are designed to meet the needs and wishes of our participants.  We hope your every visit to our center is a positive and enjoyable experience!  It is with that in mind that all understand their responsibilities and the expectations associated with participation at the Swansea COA.  SAFETY is always our top priority.   For this reason a Participation Agreement must be reviewed and be signed by all who wish to participate at the center.  A copy of this Agreement is available for viewing and/or download by scrolling at the bottom of this page.

emergency_id_cards_copy_0-175x122Medical ID Wallet Card - Carry your Emergency ID Card with you.  Fill out the attached form.  Return it to a staff member or send to the Swansea Council on Aging at 260 Ocean Grove Avenue, Swansea, MA 02777.  Our Administration Staff will prepare your card and notify you when it's ready.  It's that easy! There is no charge for this service.

Medicare Part D Plan Finder/Data Form - Current Medicare Part D beneficiaries and new enrollees are encouraged to review of their medications and Part D Drug Plan each year.  Use this form before scheduling your meeting with a SHINE (Serving Health Insurance Needs of Everyone) Counselor.

Special Needs Assistance Request Form- Emergency Help - Imagine being trapped in your home with no electricity, telephone service or heat.  What would  you do without power during a hurricane or blizzard or in the days that follow?  Fill out this form to tell us what your special needs are.  Return it to the COA and it will be shared with Emergency Responders in the event of an emergency.
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Document Center

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Forms & Documents8 documents

  • Council on Aging Code of Conduct
    document Header Council on Aging Code of Conduct
  • Council on Aging Participation Agreement
    document Header Council on Aging Participation Agreement
  • Create a My Medicare Account - Instructions
    document Header Create a My Medicare Account - Instructions
  • Emergency Medical ID Wallet Card
    document Header Emergency Medical ID Wallet Card
  • Emergency Preparedness Checklist & Hurricane Information
    document Header Emergency Preparedness Checklist & Hurricane Information
  • Part D Drug Form
    document Header Part D Drug Form
  • Silver Alert Registration Form
    document Header Silver Alert Registration Form
  • Special Needs Assistance Form
    document Header Special Needs Assistance Form