• Aetna Handicap Child Doctor Form
  Aetna HMO enrollees who have a handicapped dependent child over age 23 must have the attending physician complete this form. You should send it to Aetna along with the member form (below) per instructions on the form.
  

• Aetna Handicap Child Member Form
  Aetna HMO enrollees who have a handicapped dependent child over age 23 must complete this form annually and send it to Aetna per instructions on the form. The doctor form (above) must also be sent to Aetna.

• Affidavit of Common Law Marriage (ADM 4731)
  To enroll a common law spouse for benefits as described in the "Eligibility" section of the Health Care and Long Term Care handbook, complete and submit this form to your agency's payroll or personnel office.

• Affidavit of Dependent Status (ADM 4729)
  This affidavit should be completed by new employees who have dependents over the age of 19 who they wish to cover. For more information, see the Benefits Decision & Comparison Guide.
  
  
  

PLEASE NOTE: The free Adobe Acrobat Reader software is required in order to display and print these forms. Following the Adobe Acrobat Reader link above will take you to the Adobe Systems Web site, where you can download the latest version of Acrobat Reader. Follow the directions on the Adobe Systems Web page.

If you are unsure of which category your form falls into, click here for an alphabetized list of all available forms.