Get Wellness Grant Reimbursement Form - Washington Counties ... - Wcif

Filling out the Wellness Grant Reimbursement Form is essential for users looking to request reimbursement from the Washington Counties Insurance Fund. This guide provides clear instructions on each section and field of the form to ensure a smooth and efficient submission process.

Follow the steps to successfully complete the form.

1. Press the ‘Get Form’ button to access the form and open it in your chosen form editor.
2. Begin by completing the required fields in the form, starting with the explanation of expenses. Enter the applicable numbers for each expense in the left-hand column.
3. For each expense listed, input the amount requested in the corresponding field next to it.
4. Ensure that you attach copies of all necessary supporting documentation. This may include receipts, lists of incentive recipient names, and prizes awarded, as stipulated in the 2014 WCIF Wellness Grant Regulations.
5. Number and order all supporting documents according to their explanation of expense, matching the numbering on the form. This is crucial for proper processing.
6. In the confirmation section, verify that all expenses listed comply with the WCIF Wellness Grant Regulations. Your acknowledgment here is important to avoid any issues with reimbursement.
7. Print to sign the form, making sure to include your printed name, the date, and a contact phone number.
8. Specify the check payable to and provide a mailing address along with attention details if applicable.
9. Once all fields are completed, save your changes, then download, print, or prepare to share the document as required.

Start your online application process now and ensure your reimbursement request is submitted smoothly.