Worksafebc worker travel reimbursement form 2025

1. Click ‘Get Form’ to open the worksafebc worker travel reimbursement form in the editor.
2. Begin by filling in your last name, first name, and personal health number from your BC CareCard. Ensure these mandatory fields are completed accurately.
3. Provide your address details, including city, province/state, and postal code/zip. If your address has changed, indicate this by selecting 'Yes' or 'No'.
4. Enter your daytime phone number and WorkSafeBC claim number. These are crucial for processing your reimbursement request.
5. List the quantity and name of the medication you are claiming for, along with the drug identification number (DIN) and Rx number.
6. Fill in the amount paid by you for each medication and the date of purchase. Include any applicable amounts paid by Pharmacare.
7. Finally, certify that you incurred these expenses by signing and dating the form before submitting copies of receipts as instructed.

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