This page includes the most commonly used producer forms in PDF format for you to view, print and/or download. You will need the Adobe Acrobat reader to use them. This is only a collection of our forms. If additional forms are needed, please contact your broker representative at
Aetna.

The following documents are provided in Adobe PDF format.

• W-9 Form (PDF: 34 KB / 4 pages)
• Producer/Agent Confidential Data Sheet
  (Licensing & Appointment) (PDF: 33 KB / 3 pages)
• Corporation/Partnership Confidential Data Sheet
  (Licensing & Appointment) (PDF: 35 KB / 3 pages)
• Cobra Group Health Form - Non HMO Direct Billing
  (PDF: 19 KB / 2 pages)
• Cobra Group Health Form - Non HMO Non Direct Billing
  (PDF: 24 KB / 2 pages)
• Delaware Group Questionnaire (PDF: 15 KB / 2 pages)
• Delaware Individual Health Statement (PDF: 20 KB / 2 pages)