LHD & FORUM Wellness
Complete Your Wellness Reimbursement

Submit your expenses through this form and you’ll be notified when the request is approved.

  • Step 1 - Enter Your Contact Info

  • MM slash DD slash YYYY
  • Step 2 - Submit Your Expenses

    To submit your reimbursement request, complete the form below and attach your receipt(s). Please ensure the receipt(s) you submit shows the date of purchase, the amount to be reimbursed, and the item for reimbursement.

    Submitting your expense(s) does not guarantee reimbursement. Within 5-10 business days of your submission, you will receive an email notification that your request has been approved or denied. For questions, please call the support line at (317) 343-2746, available Monday through Friday from 9:00 am to 5:00 pm EST, or email FORUMWellness@localhost.

    FORUM Credit Union Wellness Bucks

  • MM slash DD slash YYYY
  • Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 300 MB.