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Dominion energy medical form 2025

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The document provides information on how customers with serious medical conditions can apply for a 10-day extension to their active account, including the process of completing and submitting the Serious Medical Condition Certification Form. It also outlines the procedures for reporting outages, the rights granted upon approval of the form, and clarifies that having a medical note does not exempt customers from bill payments or potential service termination due to nonpayment.

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Versions	Form popularity	Fillable & printable
2017	4.3 Satisfied (56 Votes)
2011	4.8 Satisfied (36 Votes)

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

How can I apply for a 10-day extension on my account due to a serious medical condition?

Print the Serious Medical Condition Certification Form, have your doctor complete it, and return it to us within 10 days.

What should I do if my medical condition changes?

Call us toll-free at 1-866-DOM-HELP (1-866-366-4357) to inform us of any changes in your medical condition.

What happens after I submit the Serious Medical Condition Certification Form?

We will notify you when we receive the completed form and inform you if you are eligible for the medical program.

Can I delay termination of service more than twice within a year?

No, you may only delay termination twice within a 12-month period as long as the medical form is active on your account.

Does having a medical note on my account exempt me from bill payments?

No, a medical note does not release you from bill payments or eliminate the possibility of eventual cut-off for nonpayment.

serious medical condition certification form

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Whats the phone number to Dominion Energy?

Various types of in-person payments are accepted including: Cash. Money orders (written to the authorized payment center, not to Dominion Energy)* Checks (including personal checks, travelers checks, and cashiers checks)* Pin-based debit cards (Walmart and Kroger locations) Walmart MoneyCard (Walmart locations)

What is the phone number for Dominion East Ohio?

Contact Customer Service To start or stop AutoPay, call 800-362-7557 or manage your account online.

How do I pay my Dominion Power bill in Virginia?

In-Person Cash. Money orders (written to the authorized payment center, not to Dominion Energy)* Checks (including personal checks, travelers checks, and cashiers checks)* Pin-based debit cards (Walmart and Kroger locations) Walmart MoneyCard (Walmart locations)

Who is the gas company for Massillon Ohio?

Home - Columbia Gas of Ohio.

How much is Dominion Energy deposit Virginia?

Surety Bond Dominion Energy Virginia holds this document in lieu of a cash security deposit to protect the company against loss resulting from unpaid service bills by non-residential customers. The minimum dollar amount for this application is $500.00.

Dominion energy medical form 2025

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Got questions?

How can I apply for a 10-day extension on my account due to a serious medical condition?

What should I do if my medical condition changes?

What happens after I submit the Serious Medical Condition Certification Form?

Can I delay termination of service more than twice within a year?

Does having a medical note on my account exempt me from bill payments?

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People also ask

Whats the phone number to Dominion Energy?

What is the phone number for Dominion East Ohio?

How do I pay my Dominion Power bill in Virginia?

Who is the gas company for Massillon Ohio?

How much is Dominion Energy deposit Virginia?

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