Get Reimbursement Request Form - Physicians Plus

This guide provides clear, step-by-step instructions on how to successfully complete the Reimbursement Request Form for Physicians Plus online. Follow these directions to ensure your reimbursement request is processed smoothly and efficiently.

Follow the steps to accurately complete your reimbursement request form.

1. Click ‘Get Form’ button to obtain the Reimbursement Request Form - Physicians Plus and open it in your preferred editor.
2. Enter your name in the designated field. Ensure that the name matches the name on your Physicians Plus membership.
3. Provide your current address in the address section, making sure that it is complete and accurate.
4. Input your phone number in the specified field for any necessary follow-up communications.
5. Fill in your email address to receive notifications about your reimbursement status.
6. Enter your Physicians Plus member number, which can typically be found on your membership card.
7. Specify the amount paid for the expense you are seeking reimbursement for in that section.
8. Indicate the reimbursement year by selecting the correct year from the dropdown.
9. Select the type of reimbursement you are requesting by checking the appropriate box. This section includes Health & Fitness Facility Membership, Eat Healthy Rebate, and others.
10. For each type of reimbursement selected, provide the required documentation, such as proof of payment or completion of classes, as specified.
11. For classes, complete the class name, completion date, location, and obtain the instructor's signature if applicable.
12. Confirm that all required fields are filled out, and review your information for accuracy.
13. Save your changes, and choose to download, print, or share the completed form as needed.

Submit your reimbursement request form online to take advantage of the Good Health Bonus program.