Printable Aflac Wellness Claim Form

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Post office box 84075 * columbus, ga. All forms are printable and downloadable. Aflac is not licensed to solicit business in new york, guam, puerto rico, or. Use only blue or black ink while completing this entire form. Policyholder signature date american family life assurance company of columbus (aflac) attn:

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Before Filing A Claim, Make Sure You Register Online By Creating A Myaflac® Account.

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Web I Certify That The Information Provided Is True And Correct:

Web z06197ad accident wellness benefit claim formduckducksome of the tests listed may not be covered under the wellness benefit of your policy. Sign, date, and mail or fax the completed form to the address/number shown below. Send aflac wellness claim form via email, link, or fax. On average this form takes 14 minutes to complete.

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