Request to Receive Donated PTO
If you wish to receive PTO Donation, please complete the form below. Please note you will need to submit a new request each pay period.
- Care team members in need of receiving additional PTO through the donation process, must complete a PTO Donation Request Form within 2 weeks of exhausting PTO.
- Please note only qualifying care team members who have exhausted their PTO bank and are on an approved continuous leave [associated with Family and Medical Leave (FML), Americans with Disabilities Act (ADA), Short Term Disability (STD), and Personal Leave] will be eligible to receive donated PTO.
- The following types of leave do not qualify as eligible time away under this policy: intermittent leave, leave or time missed from work associated with a work-related injury, or leave associated with bonding, military, or disaster response.
- Care Team Members who have requested to save a week of PTO are not eligible to receive PTO Donation.
- Please see the MaineHealth PTO Donation Policy https://mainehealth.ellucid.com/documents/view/16259?product=polic for more information.
For questions, please contact the Support Center via the ASK HR icon located on all MaineHealth Desktops or phone at 207-661-4000.
We encourage you to select the box at the bottom of this form to receive an emailed copy for your records.