Effective Date: July 1, 2023

Mandel Dermatology Boulder (“Mandel Dermatology,” “we,” “our,” or “us”) offers a transportation reimbursement program for current University of Colorado Boulder (“CU Boulder”) students who travel to or from our Boulder office for their dermatology appointments. Participation in this program constitutes acceptance of the following terms and conditions:

1. Eligibility

• The program is open only to current CU Boulder students.
• Students must provide a valid CU Boulder student ID when submitting their reimbursement request.
• The date of ride share travel must correspond to the date of a completed appointment at Mandel Dermatology Boulder.

2. Reimbursement Amount

• Eligible students may receive reimbursement of up to $15 total per completed visit for ride share transportation to and from the office.
• The total reimbursement applies per visit, not per trip (i.e., a maximum of $15 for a round-trip visit).

3. Definition of Ride Share

For purposes of this program, “ride share” refers to services such as Uber, Lyft, and similar transportation network companies that connect passengers with drivers via a mobile application.

4. Proof of Ride

To qualify, students must submit the following:

• Ride share receipt(s) showing:
• The total fare amount
• The start and end locations of the trip
• Either the pickup or drop-off location must be Mandel Dermatology Boulder, and the other location must be within the CU Boulder campus or surrounding area.
• A copy or image of the student’s CU Boulder ID.

5. Submission Process

• Reimbursement requests must be submitted through the official Mandel Dermatology Boulder Ride Share Reimbursement Request Form, available at:
  https://mandeldermatology.com/boulder-rideshare-reimbursement-request
• All documentation must be submitted within 60 days of the visit date.
• Requests submitted after 60 days will not be eligible for reimbursement.

6. Credit Application and Refunds

• Approved reimbursements are issued as a credit to the patient’s Mandel Dermatology account.
• Credits may be applied toward current or future balances on the account.
• If, after 60 days or once the most recent insurance claim or patient bill has been fully processed, no balance remains, the credit may be refunded upon written request submitted through the form above or by email to wecare@mandeldermatology.com.
• Refunds will be issued by check only.
• Refunds will not be issued when:
• The patient has an outstanding balance greater than the available credit, or
• There are unpaid patient or insurance claim balances on the account.

7. Abuse and Misuse

Mandel Dermatology reserves the right to:

• Deny reimbursement or credit to any individual who appears to be abusing or attempting to abuse this offer or policy, and
• Modify, suspend, or terminate the program at any time without prior notice.

8. General Terms

• This program has no cash value except as provided under these terms.
• Mandel Dermatology’s decision on eligibility and reimbursement is final.
• These terms are governed by the laws of the State of Colorado.