Request Form(s)

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 field only appears on the Internal form (i.e. for users who are logged in)

   3. A confirmation email will be sent to the given Email Address on form submission. This will not be sent if an email address is not given

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

Deliveries

As of May 15th, users who are “External” to the Office on Aging are no longer able to request box fan deliveries. Case Managers (i.e. “Internal” users) are the only ones capable of submitting delivery requests.

When an External user selects “Delivery” for Delivery Method, they receive text that instructs them to call the Office on Aging to confirm that they are homebound. A Case Manager will then submit a delivery request on the Senior’s behalf using the Internal form.