2025 Assembly Reimbursement Form

UCA will reimburse attendees up to $1000 to cover travel expenses. All expense reimbursement forms and receipts MUST be received by August 11, 2025, to receive reimbursement.

Note: Corporate members and sponsors do not received reimbursement for expenses.
Consider waiving your reimbursement so funds may be used in other pursuits for the advancement of the field of Urgent Care.
Please make sure this is the full address and is associated with your banking info.