HSA / FSA reimbursement

Get your Letter of Medical Necessity

Fill in what you know and we'll build your FITTR letter with your details already on it. Print it or save it as a PDF, then take it to your healthcare provider to complete and sign.

Your information stays on your device. Nothing you type here is sent to or stored by FITTR.
1

Which letter do you need?

2

Your information

Use your full legal name as it appears on your HSA or FSA account.

Please enter your full name.
Please enter your date of birth.
Please enter your street address.
Please enter your city.
State needed.
ZIP needed.
Please enter your phone number.
3

Program details

Choose your plan and how many months. We'll fill in the estimated cost and coverage dates for you.

Monthly price × 12 months. Change it if you paid a different amount.
Usually the date you started or will start coaching.
Set to 12 months after the start date.
Know your provider's details? Add them here (optional)

Skip anything you don't know. Your provider's office will fill in the rest.