annual employer scrubs reimbursement

Todd M. Hovis, M.D.
Lori J. Learned, M.D.
Arun G. Nayar, M.D.
Nicole H. Noska, O.D.
Keith A. Bourgeois, M.D.
John W. Miller, M.D.
ANNUAL EMPLOYER SCRUBS REIMBURSEMENT ALLOWANCE
MAY 2014-APRIL 2015 PERIOD
as of 5/1/1
EMPLOYEE SCRUB & JACKET POLICY
We’re very excited to announce that Columbus Eye Associates and Columbus Optical have decided to continue to assist employees
with the cost of their scrubs by offering an Annual Employer Scrubs Reimbursement Allowance for the time period above. The
reimbursement allowance is to help offset the cost of an Employee’s Scrubs and Jacket. The maximum Annual Employer Scrubs
Reimbursement Allowance for an employee who works an average of 40 hours per week is $205.00. Employees who work on
average less than 40 hours per week qualify to receive a prorated Annual Employer Scrubs Reimbursement Allowance for Scrubs.
The reimbursement allowance is based on the average number of hours worked per week an Employee works. Example: Employees
who works an average of 24 hours per week may receive up to 60% of the maximum reimbursement allowance for Scrubs
(24/40=60%). All Employees who work on average 20 hours per week qualify to receive a reimbursement allowance for a black
Jacket.
The maximum reimbursement allowance available for an employee who works an average of 40 hours per week is:
• The maximum reimbursement for Scrubs is ............................................................................................... $185.00
• The maximum reimbursement for a black Jacket is .................................................................................... $ 20.00
• The maximum reimbursement for Scrubs plus a black Jacket is ................................................................ $205.00
Schulenburg Printing will embroidery the Columbus Eye Associates Logo and the Employees Name (placed on the left side of the upper
portion of the top or jacket) for $5.50 each (this price is based on at least 50 items to embroidery). We have a salesperson, Susie Behlen,
who comes by the Columbus office every Monday who will take the scrubs back to Schulenburg Printing and then return them when the job
is completed.
The average cost for one set of Scrubs is $37 ($22 for Top and $15 for Bottom) and $185 for a set of five (5) sets of Scrubs.
Employees may use the reimbursement allowance toward any of the Scrubs in the Scrubs Schedule below, a Jacket or Embroidery
on the Scrub Top. Employees are responsible for ordering and purchasing their scrubs and jacket. To receive the Annual Employer
Scrubs Reimbursement Allowance each employee is required to fill out and sign the Annual Employer Scrubs Reimbursement
Allowance Voucher on the next page, attach proof of payment for the scrubs and or jacket, and then give it to Robert Burton for
processing. An example of proof would be a receipt indicating that the order was paid in full. All unsigned vouchers will be returned
and not processed. The voucher identifies what is being reimbursed, the amount being reimbursed, and states that the employee
agrees to reimburse the employer if they are not employed 12 months from the date of reimbursement. New employees are
responsible for ordering and purchasing their ten (10) sets of Scrubs and one (1) Black Jacket. New employees are eligible to be
reimbursed up to ten (10) sets (10 tops & 10 bottoms) of Scrubs and one (1) Jacket.
The new Scrubs Schedule for the May 2014-April 2015 Period is:
Week One
Monday ........... Pewter Scrubs. Solid or “Looking Good” Top.
Week Two
Monday ........... Olive Scrubs. Solid.
Tuesday .......... Red Scrubs. Solid.
Tuesday .......... Watermellon Scrubs. Solid.
Wednesday ..... Royal Blue Scrubs. Solid.
Wednesday ..... Galaxy Blue Scrubs. Solid.
Thursday ......... Sage Green Scrubs. Solid or “Looking Good” Top. Thursday .......... Black Scrubs. Solid or “Looking Good” Top.
Friday .............. Raspberry Scrubs. Solid or CEA Black T-Shirt.
Friday .............. Eggplant Scrubs. Solid or Black CEA T-Shirt.
The Scrubs Schedule above will begin on May 26, 2014 unless notified otherwise. If the beginning date changes all staff will be
notified by email and a memo will be posted in our “Daily Message” folder.
Columbus Office
Katy Office
La Grange Office
Sealy Office
100 Sweetbriar Drive
Columbus, Texas 78934
979-732-5771 – Telephone
979-732-6922 – Fax
800-460-EYES (3937) - Toll Free
21720 Kingsland Blvd., Suite 305
Katy, Texas 77450
281-829-EYES (3937) – Telephone
281-829-0599 – Fax
108 N. Washington
La Grange, Texas 78945
979-968-3953 – Telephone
979-968-3435 – Fax
2879 Hwy 36 South
Sealy, Texas 77474
979-885-0665 - Telephone
979-885-4110 – Fax
www.ColumbusEye.org
Todd M. Hovis, M.D.
Lori J. Learned, M.D.
Arun G. Nayar, M.D.
Nicole H. Noska, O.D.
Keith A. Bourgeois, M.D.
John W. Miller, M.D.
Employees can purchase Scrubs and a Jacket from the vender of their choice as long as it is the “CHEROKEE” brand. Solids are
Cherokee Authentic Work wear. A few of the recommended websites and scrub shops to order from are:
Lydias Uniforms at www.lydiasuniforms.com .
Scrubs & Beyond at www.scrubsandbeyond.com .
Uniforms City at www.uniformcity.com .
Uniform Specialists Katy. www.uniformspecialistskaty.com . 281-391-0098. Threresa Konvicka (Owner/Manager).
22145 Katy Fwy, Suite B., Katy, TX 77450. On I-10 between Grand Parkway and Mason.
• The Scrub Top Shop, Bastrop, Texas, phone #512-321-3392.
(The shop has a large variety of Cherokee scrubs to purchase or try on to make certain of your correct size.)
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•
•
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We will notify Employees throughout the year if the Scrubs schedule should change to encourage the use of holiday scrubs.
A huge THANK YOU goes out to Dr. Learned, Marlene Bradford, Annette Lindquist and Janice Wasut for selecting the new scrubs! If you have
any questions or comments please any Representative on the Employee Relations Committee.
EMPLOYEE NAME TAG POLICY
Columbus Eye Associates and Columbus Optical will provide employees with a name tag that will not damage the scrubs and jacket.
Once an employee receives a name tag employees are expected to wear their name tag when they are clocked in to work. If an
employee loses their name tag the employee will be responsible for replacing their name tag at their cost within two weeks of losing it.
Employees who do not wear their name tag on six documented incidents the employee will not be eligible for the Employer Annual
Scrub Reimbursement Allowance for the next reimbursement period but will be required to purchase the scrubs identified in the
scrubs schedule.
Thanks,
Robert
G. Burton
Bob Moore
Chief Operating Officer
Columbus Office
Katy Office
La Grange Office
Sealy Office
100 Sweetbriar Drive
Columbus, Texas 78934
979-732-5771 – Telephone
979-732-6922 – Fax
800-460-EYES (3937) - Toll Free
21720 Kingsland Blvd., Suite 305
Katy, Texas 77450
281-829-EYES (3937) – Telephone
281-829-0599 – Fax
108 N. Washington
La Grange, Texas 78945
979-968-3953 – Telephone
979-968-3435 – Fax
2879 Hwy 36 South
Sealy, Texas 77474
979-885-0665 - Telephone
979-885-4110 – Fax
www.ColumbusEye.org
Todd M. Hovis, M.D.
Lori J. Learned, M.D.
Arun G. Nayar, M.D.
Nicole H. Noska, O.D.
Keith A. Bourgeois, M.D.
John W. Miller, M.D.
ANNUAL EMPLOYER SCRUBS REIMBURSEMENT ALLOWANCE VOUCHER
MAY 2014-APRIL 2015 PERIOD
as of 5/1/14
EMPLOYEE SCRUB & JACKET POLICY
By signing this voucher I acknowledge that I am requesting reimbursement for the items below and based on the date of the check of
my reimbursement I understand that the Total Requested Reimbursement amount below must be paid back to Columbus Eye
Associates or Columbus Optical if I am not employed on the Qualifying Ending Date (12 months from the date of reimbursement)
below. If my employment is terminated and I have not paid back the amount below I authorize Columbus Eye Associates or
Columbus Optical Company, Ltd. to deduct the following Total Requested Reimbursement amount from my final pay check or my final
three pay checks if needed:
Requested Scrubs Reimbursement: $ ___________________
Requested Jacket Reimbursement: $ ___________________
Total Requested Reimbursement: $ ___________________
EMPLOYEE NAME TAG POLICY
Columbus Eye Associates and Columbus Optical will provide employees with a name tag that will not damage the scrubs and jacket.
Once an employee receives a name tag employees are expected to wear their name tag when they are clocked in to work. If an
employee loses their name tag the employee will be responsible for replacing their name tag at their cost within two weeks of losing it.
Employees who do not wear their name tag on six documented incidents the employee will not be eligible for the Employer Annual
Scrub Reimbursement Allowance for the next reimbursement period but will be required to purchase the scrubs identified in the
scrubs schedule.
Employee Name:
__________________________________________________________
Employee Signature:
__________________________________________________________
---------------------------------------------------------------------------------------------------------------------------------------------------------------(This Bottom Portion Is To Be Filled Out By Employer Representative)
--------------------------------------------------------------------------------------------------------------------------------------------------------------Total Amount of Reimbursement:
___________________
Date of Reimbursement:
___________________
Qualifying Ending Date:
___________________
Employer Representative Name:
Employer Representative Signature:
__________________________________________________________
__________________________________________________________
Columbus Office
Katy Office
La Grange Office
Sealy Office
100 Sweetbriar Drive
Columbus, Texas 78934
979-732-5771 – Telephone
979-732-6922 – Fax
800-460-EYES (3937) - Toll Free
21720 Kingsland Blvd., Suite 305
Katy, Texas 77450
281-829-EYES (3937) – Telephone
281-829-0599 – Fax
108 N. Washington
La Grange, Texas 78945
979-968-3953 – Telephone
979-968-3435 – Fax
2879 Hwy 36 South
Sealy, Texas 77474
979-885-0665 - Telephone
979-885-4110 – Fax
www.ColumbusEye.org
Week One:
***
Monday……….PEWTER
Tuesday………RED
Wednesday…..ROYAL BLUE
***
Thursday……..SAGE GREEN
Friday…………RASPBERRY
Week Two:
Monday……….OLIVE
Tuesday………WATERMELON
Wednesday…..GALAXY BLUE
***
Thursday……...BLACK
Friday…………EGGPLANT
*** "Looking Good Scrub Top may be worn on these days.