Request to Use Aetna Logo (Others)

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
2) Please answer the following questions
*Are you currently under contract with Aetna?

Please enter the name of your Aetna business contact. If you do not have a contact, please enter 'none'.

*Is your request to use the Aetna logo on Medicare materials?
*Which Aetna Logo do you want to use?

Check all that apply

*How do you want to use the Aetna Logo?
3) Please submit samples via email

Email a sample of your intended use of the Aetna Logo as an attachment to Please put your company name in the "Subject" line. The sample may be the copy for a radio or TV ad or the PDF file of a print ad or brochure.


To proceed you must read and agree to abide by the Terms of Use of the Aetna Logo by clicking on the Submit button below.


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.

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


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