Get Application For Chronic Condition Or Critical Care Residential Customer Status

Completing the Application For Chronic Condition Or Critical Care Residential Customer Status is an essential step for individuals who require specific protections regarding their electric service. This guide provides clear, step-by-step instructions for filling out the application online, ensuring that users can navigate the process with confidence.

Follow the steps to submit your application effectively.

1. Click the ‘Get Form’ button to access the application and open it for completion.
2. Complete Part 1 of the application, which requires personal information such as the customer’s name, service address, and electric service identifier (ESI ID). Ensure all fields are filled out accurately.
3. Provide the TDU by selecting the appropriate utility company based on the first seven digits of your ESI ID, including options such as AEP Texas North, CenterPoint, and Oncor.
4. Fill in the mailing address if it differs from the service address, and provide primary and secondary phone numbers, including a secondary contact's information if necessary.
5. Sign and date the application, confirming that all provided information is accurate and that you understand the implications of your chronic condition or critical care status.
6. Submit Part 1 to your physician for their completion of Part 2 of the application, which will include their signature and medical verification.
7. Once your physician has completed Part 2, they must submit the application electronically to the respective TDU using the specified contact methods such as fax or email.
8. After successful submission, ensure to save changes to your records, and if necessary, download or print the completed application for your reference.

Complete your Application For Chronic Condition Or Critical Care Residential Customer Status online today to ensure the protection of your electric service.