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Request To Use The SilverScript Logo


Thank you for your interest in using the SilverScript logo. Please complete the form below so we can evaluate your request. 
 

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

1. Please enter your contact information

(10 digits)
(10 digits)
formatted as example@sample.com

 

2. Please answer the following questions

 

formatted as www.website.com
*Are you currently under contract with Aetna
If you do not have a contact, please enter ‘none’.
*WILL THE SILVERSCRIPT LOGO BE ASSOCIATED WITH ANY MEDICARE OFFERINGS?
*HOW DO YOU WANT TO USE THE SILVERSCRIPT LOGO?
(ENTERED AS MM/DD/YYYY)

 

3. Please submit samples for our review.
 

Email a sample of your intended use of the SilverScript logo as an attachment.

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

 

Click on the Submit button below to be taken to the Terms of Use of the SilverScript logo