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Please use black or blue ink only and print legibly when completing this form in its entirety. Claims for all other benefits covered under. Save or instantly send your ready documents. Web please sign, date and mail or fax the completed form to the aflac address/fax number shown below. Before filing a claim, make sure you register online by creating.
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Failure to complete all sections may result in a delay in processing this claim. You can also file a claim as a guest if you prefer not to register. Web please sign, date and mail or fax the completed form to the aflac address/fax number shown below. You can sign up using either your aflac insurance policy number or alternate.
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Failure to complete all sections may result in a delay in processing this claim. Web wellness and health screening claim form failure to complete all sections may result in delayed processing of this claim. You can also file a claim as a guest if you prefer not to register. Web download aflac cancer screening wellness benefit claim form. Aflac also.
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Web wellness and health screening claim form failure to complete all sections may result in delayed processing of this claim. Web please sign, date and mail or fax the completed form to the aflac address/fax number shown below. Claims for all other benefits covered under. Mark only wellness exam box(es) for test(s) that you had performed.
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Save or instantly send your ready documents. Failure to complete all sections may result in a delay in processing this claim. Please use black or blue ink only and print legibly when completing this form in its entirety. Use only blue or black ink while completing this entire form.