Get Thank You For Trusting Aflac New York With Your Vision Needs - Ufadba

Filling out the Thank You For Trusting Aflac New York With Your Vision Needs - Ufadba form is a crucial step in managing your vision claim effectively. This guide provides clear, step-by-step instructions to help you navigate the process smoothly, ensuring all necessary information is completed accurately.

Follow the steps to successfully complete your vision claim form online.

1. Click the ‘Get Form’ button to access the form online and open it in your preferred document editor.
2. Begin by entering your policy number in the designated field. This identification number is essential for linking your claim to your account.
3. Complete the policyholder information section, ensuring to fill out all required fields marked with an asterisk (*). This includes your last name, first name, middle initial, date of birth, and contact telephone number.
4. Provide your home address, including city, state, and zip code. If this address is a permanent change, check the corresponding box.
5. Fill out the patient information section with the same level of detail. Include the patient's last name, first name, date of birth, sex, and relationship to the primary policyholder.
6. Next, move to the vision checklist. Indicate the nature of the claim by selecting whether it is due to an injury or sickness. Make sure to provide the date and details regarding the injury.
7. Specify the condition for which the claim is being filed, check the appropriate boxes, and describe the first date of treatment.
8. For any additional medical documentation related to your claim, gather and prepare to submit them for review.
9. Complete the section regarding the primary treating physician for the patient, providing their name, phone number, and address.
10. If applicable, answer questions about other physicians who treated the condition and any surgical procedures performed. Include relevant details where necessary.
11. Confirm if the patient experienced any level of permanent visual impairment by checking the applicable options.
12. Finally, review your information for accuracy, then save changes to your completed form. You may also download, print, or share the form as necessary.

Complete your vision claims form online today for a smooth processing experience.