Pge medical baseline 2026

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The document is a Medical Baseline Allowance Self-Certification Request Form from Pacific Gas and Electric Company (PG&E). It outlines the process for customers to certify their eligibility for additional energy allowances due to medical needs. The form requires customer and resident information, details on the medical condition's permanence, and preferences for outage notifications. It emphasizes the need for annual or biennial self-certification based on the medical condition and provides instructions for submitting the application.

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Click ‘Get Form’ to open the Medical Baseline Allowance Self-Certification Request Form in the editor.
Begin with Step 1, where you will enter your PG&E customer account number, your name as it appears on the bill, and the service address. Ensure all information is accurate for a smooth process.
In Step 2, if applicable, provide details for customers billed by someone other than PG&E. Include the name of your mobile home or apartment complex and its address.
Proceed to Step 3 to select your preferred contact method for planned or unplanned outages. You can choose up to two methods and provide relevant contact information.
Finally, in Step 4, sign and date the form to certify that all provided information is correct. This step is crucial for processing your request.

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Versions	Form popularity	Fillable & printable
2018	4.8 Satisfied (80 Votes)
2013	4.4 Satisfied (141 Votes)
2002	4.2 Satisfied (46 Votes)

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