Get Smud Forms 1519c

Filling out the Smud Forms 1519c online can streamline your application for medical equipment discounts provided by the Sacramento Municipal Utility District. This guide will walk you through each section of the form, ensuring you complete it accurately and efficiently.

Follow the steps to successfully complete your application.

1. Click the ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by providing your customer information. Fill in your last name, first name, service address, city, state, and ZIP code. You will also need to enter your SMUD account number and the name of the person qualifying for the MED Rate.
3. If your mailing address differs from your service address, please provide that information to ensure accurate correspondence.
4. In the patient name section, you must enter the name of the person residing in your household who requires the medical equipment.
5. Sign and date page one of the application as the account holder. This step is crucial as it certifies that all your information is accurate.
6. Have a licensed qualified health professional complete and sign page two of the application, certifying the necessity of the medical device.
7. After completing the form, ensure all sections are filled accurately. Save your changes and download a copy if necessary.
8. Finally, print the completed application and mail it to the Sacramento Municipal Utility District at MED Rate, Mail Stop A104, P.O. Box 15830, Sacramento, CA 95852-0830.

Start filling out your Smud Forms 1519c online today to take advantage of available medical equipment discounts.