Fl 192 2026

1. Click ‘Get Form’ to open FL-192 in the editor.
2. Begin by entering your name and contact information at the top of the form. This ensures that all parties are aware of who is submitting the document.
3. In Section 1, provide an itemized statement of any healthcare costs incurred that were not covered by insurance. Be sure to include dates and descriptions for clarity.
4. For Section 2, if you have already paid these costs, attach proof of payment and specify the amount you are requesting for reimbursement from the other parent.
5. Complete Section 3 by indicating whether you have used a preferred health provider as designated by court order. If not, explain why alternative providers were utilized.
6. Review all entries for accuracy before saving your changes. Utilize our platform’s features to sign electronically if required.

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