Y 4x 2 3 2x 5

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Y 4x 2 3 2x 5

Y 4x 2 3 2x 5

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Y 4x 2 3 2x 5Claims 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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Wellness and health screening claim form

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