California Medical Mileage Expense Form

State:
California
Control #:
CA-SKU-4859
Format:
PDF
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Description

Medical Mileage Expense Form The California Medical Mileage Expense Form is a form issued by the State of California for individuals to submit claims for reimbursement of medical-related travel expenses. The form is used to reimburse members of the public for mileage costs incurred when traveling to and from medical appointments or services, or to and from any other place for medical services, care, or treatment. The form is designed to collect information such as the reason for the trip, the dates of the trip, the mileage traveled, the total cost of the trip, and the name and address of the medical provider. There are two types of California Medical Mileage Expense Forms: the Standard Mileage Expense Form (SME) and the Special Mileage Expense Form (SMELLS). The Standard Mileage Expense Form is used to request reimbursement of standard medical mileage expenses, such as mileage to and from a doctor's office or hospital. The Special Mileage Expense Form is used to request reimbursement for special medical mileage expenses, such as mileage for a patient to attend a specialized medical treatment or to visit a specialist.

The California Medical Mileage Expense Form is a form issued by the State of California for individuals to submit claims for reimbursement of medical-related travel expenses. The form is used to reimburse members of the public for mileage costs incurred when traveling to and from medical appointments or services, or to and from any other place for medical services, care, or treatment. The form is designed to collect information such as the reason for the trip, the dates of the trip, the mileage traveled, the total cost of the trip, and the name and address of the medical provider. There are two types of California Medical Mileage Expense Forms: the Standard Mileage Expense Form (SME) and the Special Mileage Expense Form (SMELLS). The Standard Mileage Expense Form is used to request reimbursement of standard medical mileage expenses, such as mileage to and from a doctor's office or hospital. The Special Mileage Expense Form is used to request reimbursement for special medical mileage expenses, such as mileage for a patient to attend a specialized medical treatment or to visit a specialist.

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California Medical Mileage Expense Form