REIMBURSEMENTS
2021 Guidelines
GENERAL
All reimbursements must be submitted within 30 days of service/receipt, NO EXCEPTIONS
Receipt or proof of service must be uploaded here. If it is not 100% clear it will need to be sent via email
Contract must be on file to be reimbursed
All reimbursement is submitted via zelle or paypal
Not everything is eligible for reimbursement so please review your contract
VETTING
All receipts/documentation/reimbursement form must be submitted within 30 days of services.
When submitting VETTING services you MUST submit the entire medical encounter. You CAN NOT JUST SUBMIT THE RECEIPT
You MUST have your vet send us the encounter and receipt DIRECTLY VIA EMAIL
iHeartGuardians@gmail.com
for Guardian Home Dogs
iHeartMiniAussies@gmail.com
for non-Guardian Home Dogs
MOBILE CLINIC - just scan/send the receipt they provide you at time of service (this has the entire record and receipt)
Submit reimbursement form regardless of how receipts are being sent
Not all vetting is eligible for reimbursement. Check your GUARDIAN HOME CONTRACT for details
We do not reimburse for Heartworm Tablets but we DO reimburse up to $35 for heartworm test annually
All medical records and receipts will be reviewed and processed before determining final reimbursement
EXAM FEES, WASTE FEES AND BIOHAZARD FEES ARE NEVER ELIGIBLE FOR REIMBURSEMENT
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Purchases/Expense Reimbursement Form
one dog per form
Name of Dog
*
This dog is a :
GUARDIAN HOME DOG
STUD WITHIN THE COMPANY
PET THERAPY DOG
TRIAL GUARDIAN HOME DOG
PREVIOUS PUPPY
PUPPY WITH A DEPOSIT
BREEDER SENDING DOG TO US
DOG - OTHER
BUSINESS EXPENSE NOT RELATED TO A SPECIFIC DOG
REIMBURSEMENT IS FOR:
VETTING 0-12 MONTHS
VETTING ANNUAL VISIT
ANNUAL HEARTWORM TESTING
RABIES 1 YEAR
RABIES 3 YEAR
OFA HIPS/ELBOW/PATELLA
OFA EYE
OFA - OTHER
OTHER - RELATED TO VETTING
LIFE'S ABUNDANCE KIBBLE
RAW DIET
DOG SHOW RELATED
AKC STAR PUPPY
CGC
TITLE or ENTRY FEE
RETURN DEPOSIT
OVERPAYMENT PUPPY
EMPLOYEE PAY
LITTER BONUS
STUD PAY
DOG MIDWIFE
BOARDING
FLIGHT NANNY
OTHER - SEE COMMENTS
BRIEF DESCRIPTION ON WHAT IS BEING REQUESTED FOR REIMBURSEMENT
IF REQUESTING VETTING PLEASE WRITE
IS REIMBURSEMENT FORM BEING SUBMITTED WITHIN 30 DAYS OF SERVICE/RECEIPT?
YES
NO
Full Name
*
First Name
Last Name
Phone Number
-
Area Code
Phone Number
E-mail
*
Your E-mail Address
DATE OF RECEIPT OR SERVICE
-
Month
-
Day
Year
Date
Expenses List
Purchase Date
Product/Service Description
Cost
1
2
3
4
5
Total Cost
*
Upload invoice/receipt
Browse Files
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of
Take Photo
REIMBURSEMENT DETAILS
*
ZELLE ACCOUNT - PUT YOUR PHONE NUMBER OR EMAIL DEPENDING ON HOW YOUR ZELLE IS SET UP
PAPER CHECK : LIST MAILING ADDRESS IF NO ZELLE
FIRST NAME ON ACCOUNT
LAST NAME ON ACCOUNT
BSB
ADDITIONAL INFORMATION YOU WOULD LIKE US TO KNOW ON THIS REIMBURSEMENT
I certify
*
I certify that all information entered above is valid and true. I am also aware that reimbursement is based on a set schedule and fee and I may or may not be reimbursed for this item. Reimbursement must be submitted within 30 days of service/receipt no exceptions. Photo of receipt must be clear and readable. In most cases vet records must be sent directly from the vet office to us via email.
Signature
*
Clear
Submit Form
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ADMIN ONLY BELOW
ELIGIBLE SUBMISSIONS
8-12 WEEK VETTING
12-16 WEEK VETTING
16-20 WEEK VETTING
1 YEAR RABIES
3 YEAR RABIES
ANNUAL VETTING
OFA HIPS/ELBOW/PATELLA
OFA EYES
OFA - OTHER
DOG SHOW RELATED
HEARTWORM TESTING
LIFE'S ABUNDANCE
RAW
GROOMING
VITAMINS
SUPPLIES
HEALTH GUARENTEE REIMBURSEMENT
STUD FEE
DOG MIDWIFE
BOARDING FEE
DEPOSIT RETURN
OVERPAYMENT RETURN
EMPLOYEE PAY
PARTNER TO PARTNER BUSINESS
NOTHING ELIGIBLE
COMMENTS ON ELIGIBLE SUBMISSIONS:
What is the total reimbursement being paid out?
REIMBURSEMENT PAID?
YES
NO
WHICH ZELLE BANK ACCOUNT DID WE SEND FROM?
CHASE
BANK OF AMERICA
WELLS FARGO
NAVY FEDERAL CREDIT UNION
OTHER BANK
COMMENTS ON ITEMS NOT ELIGIBLE FOR REIMBURSEMENT (IF APPLIBACLE)
PERSON COMPLETING FORM
First Name
Last Name
TITLE OF PERSON COMPLETING FORM
Signature
Clear
DATE COMPLETED
-
Month
-
Day
Year
Date
Should be Empty: