Reimbursement Request

Please submit the reimbursement request form by the 3rd Saturday of each month.  Checks will be issued the 3rd Sunday of each month.  Please allow for 5-7 business days for checks to arrive.

Support Servcies Reimbursement

Responsible Party

DSAT will issue reimbursement check to this individual and mail to this address

Individual w/ Down syndrome

example:  07/25/2009

Service Details

select only one

Reimbursement Details

example:  $40/hour

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