Parent(s) 2019 Medical/Dental Expense Form

The Office of Financial Aid requires the following information to verify the medical/dental expenses your parent(s) reported on your financial aid application.

Please itemize all out-of-pocket medical and/or dental expenses paid by your parent(s) in 2019. Include below the name of the practitioner or agency paid, payment amount and date, and which family member the expenses were for. Do NOT include expenses that were covered by insurance, expenses that were incurred but have not yet been paid, pre-tax insurance premiums, or self-employed insurance premiums already accounted for on your parent’s Form 1040.

Once you have submitted this form, email supporting documentation to finaid@cmc.edu of all payments made for each family member, such as physician’s office or pharmacy account statements showing amount paid, receipts, or cancelled checks. If documentation is not available, please submit a written explanation of how the itemization was completed without supporting documentation.  Please do not send copies of medical records