Synchrony Rehab License Reimbursement Application
Eligibility Information
Terms of eligibility
Full-Time Team Members (who are regularly scheduled for 30 hours or more per week)
Part-Time Team Members (scheduled for 15-29 hours per week)
This program is specifically to reimburse Therapists for their
State License Fees
in the clinician's primary state of practice
Documents to submit
for reimbursement of eligible expenses
A full-page, itemized, clear copy of the
payment receipt
of the
license fee
, paid for by the clinician. We must be able to see all pertinent information (i.e. vendor, date, amount, etc.)
Clear, full-page copy of the updated
license certificate
(showing the new time-frame/end-date for this license)
NOTE: All relevant documentation must be provided within 30 days of the month the expense was incurred in order to be eligible for full reimbursement. If documents are not received within 30 days, reimbursement is reduced by 50%, if not received within 60 days, monies will not be reimbursed.
Who do I reach out to if I have questions?
Your Area Manager
Applicant Information
Applicant Name
Employee ID
If you are not sure what your Employee ID # is, input your Trilogy University Username numbers only. For example, if your username is TURNER14423, only type in 14423.
Cell Phone
Email Address
Your Discipline
Please select...
OT
COTA
SLP
PTA
PT
Other
Please Attach a full-page, itemized, clear copy of the
payment receipt
of the
license fee
, paid for by the clinician.
Please Attach a clear, full-page copy of the updated
license certificate
.
Disclaimer
**Please note that the information you are providing below is preliminary for your Area Manager to make their initial decision regarding your request.
Contact Information