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Flex Funds Service Ticket Recipient Name Date of Service Recipient CIS Number Date of Birth Fund Policy Statement and Request Requirements Mercy Maricopa may provide funding for behavioral health recipients who are adults children and their families or those who have substance abuse issues. Flex funds will be approved subject to availability. Service Description as applicable Purpose Detailed Description Select One General Vendor Services Housing/ Notice of Eviction Utilities/ Shut-off Notice...

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Click on the 'Service Tickets' option in the menu.

03

Click on the 'Create New Ticket' button.

04

Select the appropriate category and subcategory for the issue.

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Fill in the required information such as your name, contact details, and a detailed description of the problem.

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What is flex funds service ticket?

Flex funds service ticket is a form used to request funds for flexible spending accounts or reimbursement of eligible expenses.

Who is required to file flex funds service ticket?

Employees who participate in a flexible spending account program may be required to file a flex funds service ticket.

How to fill out flex funds service ticket?

To fill out a flex funds service ticket, the employee must provide their personal information, details of the expenses incurred, and any supporting documentation.

What is the purpose of flex funds service ticket?

The purpose of a flex funds service ticket is to request reimbursement for eligible expenses paid out of a flexible spending account.

What information must be reported on flex funds service ticket?

The flex funds service ticket must include the employee's name, date of the expense, description of the expense, amount requested for reimbursement, and any supporting documentation.

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