Get Hopelink Parking Reimbursement

Filling out the Hopelink Parking Reimbursement form online is a straightforward process designed to help users easily request reimbursement for parking, bridge toll, or ferry service costs. This guide will walk you through each section of the form to ensure that you complete it accurately and efficiently.

Follow the steps to fill out the Hopelink Parking Reimbursement form

1. Press the ‘Get Form’ button to access the Hopelink Parking Reimbursement form and open it in your preferred editor.
2. Begin by entering the patient or client information. Fill in the driver’s name, and if applicable, include the parent or legal guardian's name. Ensure you enter the driver's license expiration date as well.
3. Provide the address, city, and zip code of the driver. Next, note the vehicle registration expiration date and a valid phone number.
4. Input the patient/client's ProviderOne ID number and the insurance policy expiration date. Review these details to avoid any errors.
5. Complete the appointment information by noting the appointment date and time, as well as the facility name and address where the appointment will occur.
6. Indicate the medical reason for the appointment. This information helps justify the reimbursement request.
7. Specify the type of reimbursement being requested, either parking, toll, or ferry, and enter the corresponding amount spent. If you have more appointments, you can use additional forms.
8. Attach all original receipts related to the reimbursement request, ensuring that no copies are submitted. Remember that receipts should not be older than two months.
9. If the patient is a minor child and a parent or legal guardian is listed, the reimbursement check will be made payable to them. Otherwise, it will be made payable to the patient or client.
10. Sign the form as the client or parent/legal guardian, along with a signature from the driver. This acknowledges the agreement to release Hopelink from any liability related to the transportation service.
11. Once the form is fully completed and signed, mail the form and attached receipts to Hopelink Transportation at the provided address: 14812 Main St, Bellevue, WA 98007. Please allow up to 60 days for payment.

Start filling out your Hopelink Parking Reimbursement form online today to ensure timely processing of your reimbursement.