Employee Fitness Benefit Reimbursement Request

Employee Fitness Benefit Reimbursement Request — Form Fields

This hr template includes 10 fields. Request reimbursement for gym memberships, fitness classes, or wellness apps under the company fitness benefit. Free to customize and use on ZenBuild.

• Employee Full Name (text, required)
• Employee Email (email, required)
• Employee ID (text, required)
• Department (text, required)
• Expense Type (dropdown selection, required) — options: Gym membership, Fitness class pass, Wellness app subscription, Home gym equipment, Personal training sessions, Other
• Provider or Vendor Name (text, required)
• Amount to Reimburse (USD) (number, required)
• Expense Date(s) (text, required)
• Receipt or Invoice (file upload, required)
• Brief Description of the Benefit Used (long text, optional)