Who needs to be the witness?
Form A requires one witness signature. This can be the designated fund liaison at your hospital, HR department, a supervisor, a manager or a co-worker.

Does Form A need to be notarized?
No.

What address should I put down on Form A, where I am currently living or my damaged residence?
Please put down the address where you receive your mail.

Who is the fund liaison at my hospital?
It varies from hospital to hospital. Many hospitals have designated a contact in their HR department or Employee Assistance Program to be the liaison to this fund. If your HR department is not the liaison, please contact your administration department or an executive assistant.

Once Form A is completed, where do I submit it?
Please turn it into the fund liaison at your hospital. They will be responsible for submitting all forms to THA and will verify applicants are hospital employees.

Do I send my Form A to THA?
Please turn in your Form A to the fund liaison at your hospital. That person will submit the form on your behalf.