2 5 X 14

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2 5 X 14

2 5 X 14

For information or to check claim status visit aflac or call 1 800 99 AFLAC 1 800 992 3522 Claims may be faxed to 1 877 44 AFLAC 1 877 442 3522 Aflac Group Wellness Claim Form_2020. WELLNESS AND HEALTH SCREENING CLAIM ... Policy/Certificate Holder's First Name (Print): Policy/Certificate ...

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2 5 X 14Claims for all other benefits covered under this policy must be filed separately using the claim forms available at aflac.com or by calling 1-800-99-AFLAC. (1- ... Wellness Form specifically tailored for your policy Please use black or blue ink only and print legibly when completing this form in its entirety Keep a

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