Request for permission to use the Aetna logo

 

Thank you for your interest in using the Aetna Logo. Please complete the form below so that we can evaluate your request.

All fields marked with a RED asterisk(*) are required in order to proceed.

     
1 Please enter your contact information:

*:
*:
*:
:
*:
 
 :
 :  
 
 : -
(12345-6789)
 
  - -
(000-123-4567)
 
: - -
(000-123-4567)
* :
(example@sample.com)

2 Please answer the following questions:

* :
(i.e., http://www.website.com)
*:  
:
*      
:

:

* :  Aetna

 Aetna Foundation

*
*
Use the Aetna Logo as a link to the Aetna.com website
Display the Aetna Logo on my website without linking to the Aetna.com website
Please provide website address:

Brochure
Please submit sample for review
Print ad
Please submit sample for review
Name of Publication:

TV or radio ad
Please submit sample for review
Other
Please explain:

*:
*

3 Please submit samples or Fax to 860-273-7764:

Email a sample (under 8 MB) of your intended use of the Aetna Logo as an attachment to LogoLicenseRequestBox@aetna.com. Please put your company name in the "Subject" line.



* Sample may be the copy for a radio or TV ad or the PDF file of a print ad or brochure.


Before we can process your request, you must first read and agree to the Terms of Use of the Aetna logo. Click the submit button below to access and read our terms of use.



 

Information Sessions

Your request has been sent successfully if you receive a confirmation after clicking the "Submit" button.

Important! Please check this form carefully before clicking on the "Submit" button. Some browsers will not keep your information, and you will have to re-type all of it if you miss filling in any of the required fields.