Page Comparison

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1. Press Submit New Request to open form

2. User must indicate that they are at least 60 years old for the form to appear

3. A few things to note:

   1. You must check “Are you homebound / unable to leave your home without assistance?” to request a delivery

   2. The comments and Case Manager fields only appear Comments field only appears on the Internal form (i.e. for users who are logged in)

   3. A confirmation email will be sent to the Contact Email Address on form submission

4. Once you click Save, you will be taken to a confirmation page. You can return to the landing page by clicking the FCOA logo in the top-left

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