CME+Examples

=CME REIMBURSEMENTS=

This page has been put together to assist you in getting your reimbursements as quickly and easily as possible by explaining what the Auditor/Controller's office is looking for on your requests. Below is a description of what is needed for each type of reimbursement. Hard copies of the forms are available from the Medical Staff Office or you may download the blank forms using the links below.

When you have completed the forms please send them interoffice mail to:

CHRIS HOUSER MEDICAL STAFF OFFICE 331 C STREET MARTINEZ, CA

=Courses and Conferences (and exams)= 1) Travel Demand . [| BLANK FORM HERE]
 * Must have original signature. Photocopies, faxes, and scanned items are not an acceptable demand on the County of Contra Costa.
 * Name must be Last name first then a comma and then your first name. Please print legibly to keep your demand from being returned or delayed
 * Only one month of items can be on each demand and it can not be turned in before the end of the month or it will be returned.
 * Be sure to check your print settings (this form MUST be printed EXACTLY as shown).

2) Receipt
 * The receipt must show YOU as the person who paid. The Auditor's don't want to see a different name on the receipt (no, not even your spouse). If the receipt is in a another person's name you will need to show proof of a joint checking account or that you paid the person back (for example a cancelled check).

3) Training Request [| BLANK FORM HERE]
 * This form is outdated and a bit confusing, but basically if you put the title of the course, the dates you attended, and the amount you paid that is sufficient.
 * Don't forget to sign it

4) Certificate of Completion
 * Course must be completed before you can be reimbursed and a Certificate of Completion (or letter of passing exam) is required as proof.

I have attached an example of a perfectly completed Course reimbursement request:

=Computer, laptop, cell phone, tablets= 1) Travel Demand [|BLANK FORM HERE]
 * Must have original signature. Photocopies, faxes, and scanned items are not an acceptable demand on the County of Contra Costa.
 * Name must be Last name first then a comma and then your first name. Please print legibly to keep your demand from being returned or delayed
 * Only one month of items can be on each demand and it can not be turned in before the end of the month or it will be returned.
 * Be sure to check your print settings (this form MUST be printed EXACTLY as shown).

2) Computer Agreement Form [|BLANK FORM HERE]
 * All electronic purchase reimbursement requests must be accompanied by a signed Computer Agreement Form

3) Receipt
 * The receipt must show YOU as the person who paid. The Auditor's don't want to see a different name on the receipt (no, not even your spouse). If the receipt is in another person's name you will need to show proof of a joint checking account or that you paid the person back (for example a cancelled check).

I have attached an example of a perfectly completed reimbursement request for Electronics: = = =Medical Books, Medical Journals, and Board Dues= 1) Travel Demand [|BLANK FORM HERE]
 * Must have original signature. Photocopies, faxes, and scanned items are not an acceptable demand on the County of Contra Costa.
 * Name must be Last name first then a comma and then your first name. Please print legibly to keep your demand from being returned or delayed
 * Only one month of items can be on each demand and it can not be turned in before the end of the month or it will be returned
 * Be sure to check your print settings (this form MUST be printed EXACTLY as shown).

2) Receipt
 * The receipt must show YOU as the person who paid. The Auditor's don't want to see a different name on the receipt (no, not even your spouse). If the receipt is in another person's name you will need to show proof of a joint checking account or that you paid the person back (for example a cancelled check).

If you have any questions please contact Chris Houser at chouser@hsd.cccounty.us Emails are answered promptly.

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