Check Request - DASA
PhD Student Practicum Medical Expenses Reimbursement

Instructions:

This form is to be used by students to prepare PhD student practicum medical expense reimbursement. 

Students, please click the link to the instructions and read them carefully while filling out the Check Request Reimbursement Form. 

Please contact Alicea Evans, aevans@paloaltou.edu if you have any questions regarding filling out the form.

Step 1: Please fill out your name and email

Step 2: Click submit

Step 3: You will receive an email with a link to finish filling out your form

(Please note: It may take 5-10 minutes for this email to appear in your inbox, PLEASE DO NOT INITIATE A SECOND FORM)