Invoice for services provided - Canadian Mental Health Association ... - wwd cmha 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the 'Name of Client' in the designated field. This identifies who received the services.
3. Next, fill in the 'Name of Coordinator' responsible for overseeing the services provided.
4. Indicate whether reimbursement should be sent to a Parent/Guardian or an Independent Contractor by checking the appropriate box.
5. In section A, enter the 'Dates Services Provided'. In section B, input the 'Number of Hours/Kilometres', and in section C, specify your 'Hourly/Kilometre Rate'.
6. Calculate your total reimbursement by multiplying total hours/kilometres (B) by your rate (C) and enter this amount in section D.
7. Select which fund will cover the reimbursement from options provided. Ensure a box is checked to avoid processing delays.
8. Obtain necessary signatures from both the Parent/Guardian and Independent Contractor to confirm services received and payment acknowledgment.
9. Finally, provide full name and address for reimbursement processing. Check if there’s a change of address if applicable.

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