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Medical Baseline Program Recertification Request STEP 1 Account and Customer Information (Please print.)PG&E CUSTOMER ACCOUNT NUMBERCUSTOMER FIRST AND LAST NAME (as it appears on PG&E bill)RESIDENT

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How to fill out pge medical baseline form

01

Start by downloading the PGE Medical Baseline form from the official PGE website.

02

Fill in your personal information such as name, address, and contact details.

03

Provide your PGE account number and service address for easy identification.

04

Indicate your medical condition that requires the use of additional energy due to medical equipment or life-support devices.

05

Attach any necessary supporting documents such as a letter from your medical provider or medical equipment specifications.

06

Sign and date the form to acknowledge the accuracy of the information provided.

07

Submit the completed form either by mail or electronically through the PGE website or customer service portal.

Who needs pge medical baseline form?

01

Individuals who have a medical condition that requires the use of additional energy due to medical equipment or life-support devices may need the PGE Medical Baseline form. This form helps them receive a discounted rate on their electricity bill to offset the increased energy consumption.

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What is pge medical baseline form?

The PG&E Medical Baseline Form is a document that allows customers to receive a discount on their electricity bill by certifying that someone in their household has a medical condition that requires the use of certain medical equipment.

Who is required to file pge medical baseline form?

Customers of PG&E who have a household member that requires the use of medical equipment due to a medical condition are required to file the PG&E Medical Baseline Form.

How to fill out pge medical baseline form?

Customers can fill out the PG&E Medical Baseline Form online, by mail, or by calling PG&E's customer service. The form requires information about the household member with the medical condition, the medical equipment being used, and a medical provider's signature.

What is the purpose of pge medical baseline form?

The purpose of the PG&E Medical Baseline Form is to provide a discount on electricity bills for customers who have a household member with a medical condition that requires the use of medical equipment.

What information must be reported on pge medical baseline form?

The PG&E Medical Baseline Form requires information about the household member with the medical condition, the medical equipment being used, and a medical provider's signature.

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