Healthcare Travel Mileage and Expenses Log
Prepared by: [Your Name]
Date: [DATE]
Company Name: [Your Company Name]
This log is designed to record mileage and associated expenses for healthcare-related travel. It provides a structured and professional approach to tracking travel distances and costs incurred during medical appointments, treatments, and visits, ensuring accurate documentation for reimbursement and financial reporting purposes.
Log Overview
DATE | HEALTHCARE DESTINATION | ODO READING (START - END) | MILES TRAVELED | EXPENSES |
|---|
2050-07-01 | Dr. Smith’s Clinic | 50,000 - 50,120 | 120 | $30 |
2050-07-05 | PT Clinic | 50,120 - 50,180 | 60 | $15 |
2050-07-10 | Dr. Johnson’s Office | 50,180 - 50,250 | 70 | $20 |
2050-07-15 | General Hospital | 50,250 - 50,330 | 80 | $25 |
2050-07-20 | Diagnostic Center | 50,330 - 50,410 | 80 | $30 |
2050-07-25 | Emergency Room | 50,410 - 50,490 | 80 | $40 |
| | | | |
| | | | |
| | | | |
| | | | |
Reminders:
Verify Dates: Ensure all dates are correct and match the travel schedule.
Check Mileage: Confirm mileage is accurately recorded using odometer readings or a tracking app.
Expense Receipts: Attach all receipts to the log for verification.
Review Reimbursements: Submit the log for reimbursement promptly at the end of each month.
Keep Copies: Maintain a backup copy of the log for your records.
Log Templates @ Template.net
