Request for Benefit Verification
By completing this form, you will send an automatic email to your consumer's case manager asking them to complete the Hardship PTO Verification form. This form is required for you to receive your COVID-19 Hardship PTO benefit.
Please note that the Trust does not guarantee the privacy of information that you or your consumer’s case manager submit to the Trust using JotForm. If you have any concerns regarding the use of JotForm to provide this information, you may instead contact your consumer’s case manager through email, phone, or other means, and request that they complete the Benefit Verification Form available on the Trust website: orhomecaretrust.org/hardship-pto.