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Center for Care Innovations - Reimbursement Request. 

To request a reimbursement from the Center for Care Innovations (CCI), please complete the following reimbursement request within 30 days of original expense date. 


Each line item must have corresponding itemized receipt with proof of purchase. 


Have a mileage reimbursement? 

Complete this mileage form, input the total reimbursement amount as an itemized expense below and upload the completed mileage form in lieu of a receipt.


For any questions regarding your reimbursement, please contact accounting@careinnovations.org. You will be contacted by CCI if there are any questions or missing components for the request. 


Payments are sent 1-2 weeks after your request is successfully submitted.

Reimbursement Recipient




Individual Reimbursement






Organization Reimbursement
If you have a current contract with CCI, please do not use this form. Submit your expenses as an invoice and attach itemized receipts.





Expense Detail











                                                                                             If you have another expense to add, click below 👇
Payment Information



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