Reimbursement Request for Physician Mission Trip

Form For: ACTIVE SWMC PHYSICIANS ONLY

REQUIREMENTS

  • Mission Committee Approval
  • Faith-Based Medical Mission
  • Coverage for absence
  • 30 day advance notice

Physicians must request approval from their individual department and the Missions Committee for either Medical Missions time off or Ministry Trip time off, including both short-term missionary leave and long-term missionary leave.

To request Mission Committee approval for a missions trip, please complete the following information.

PREFERRED

  • Post Trip Report

Once you return home we would like to hear about your experience and how God moved while you were abroad. You can share your report with us in one of the following ways.

  • Email your report (including pictures) to swmcfoundation@gmail.com
  • Prepare a Powerpoint and share on-line
  • Share in person at various SWMC locations

Please contact the SWMC Administrator at swmcfoundation@gmail.com with your preferred preference.

Name(*)
Please let us know your name.

Your Email address:(*)
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Dates of Trip(*)
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Location of Trip(*)
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Sponsoring Organization or Agency(*)
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Purpose of the Trip(*)
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Physician or Providers Covering(*)
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Date of Departmental Approval(*)
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