[Medical Reimbursement] Finance Department

Instructions:

hopefully this:

  1. is easier than printing, signing, scanning and sending
  2. is safer than walking around asking people to sign during pandemic
  3. is less worrisome than sending around electronic photos of signature
  4. fills up the gap of google form for not having signatures
  5. enables the creation of online forms faster than development of systems for each form

 


Medical Reimbursement
Finance Department

user: Login for workers with AOLIS Account | Login for Students with AOLIS Account | Login with @aup.edu.ph AUP Email account | | time: Tue Dec 7 22:14:25 PST 2021 , forminstanceid: 0 Last signed: . Last edited: . | Signatures/Approvals: 0/0

Name

Date

Signed Authorization

Updated Prescription

Official Receipt

Medical Certificate (if necessary)


Medical

Authorized Physician Verification
Please login to Approve/Decline/Sign.

Bill

Aid

Health Service Director
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Assistant VP for Finance / VP Finance
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Optical

Authorized Physician Verification
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Bill

Aid

Health Service Director
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Assistant VP for Finance / VP Finance
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Dental

Authorized Physician Verification
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Bill

Aid

Health Service Director
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Assistant VP for Finance / VP Finance
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Total Bill

Total Aid

Total

Reimbursee
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