Lodi, CA · San Joaquin County
Residential Medical Discount Program Application
Lodi Electric Utility customers use this application to request a residential electric bill discount for a household member with qualifying medical needs.
What this form is
This application requests a 25% discount on qualifying monthly electric charges for a full-time household resident with a qualifying medical condition. The customer provides account and contact information, signs and dates the application, and has a qualified health care professional complete and sign the medical section. The discount is not retroactive, and approved customers must renew their application every two years.
Who needs it
A Lodi Electric Utility customer may apply if a full-time resident at their primary residence has a qualifying medical condition requiring life support equipment or special heating or cooling.
How to submit it
Mail the completed application with original signatures to Lodi Electric Utility, Attn: Medical Discount, 1331 S Ham Lane, Lodi, CA 95242; faxed or emailed applications are not accepted.
About notarization
This application is signed without a notary; the customer and qualified health care professional sign and date their sections.
How to submit this form
- 1
Download The Application
Download the Residential Medical Discount Program Application.
- 2
Complete Customer Information
Enter the customer’s account and contact information and the qualifying patient’s name, then sign and date the customer section.
- 3
Have The Medical Section Completed
Ask a qualified health care professional to complete and sign the medical section.
- 4
Mail The Application
Mail the completed application with original signatures to Lodi Electric Utility, Attn: Medical Discount, 1331 S Ham Lane, Lodi, CA 95242.
Frequently asked questions
- Who can apply for the Residential Medical Discount?
- A Lodi Electric Utility customer may apply when a full-time resident of the primary household has a qualifying medical condition requiring life support equipment or special heating or cooling.
- What information and signatures does the application require?
- The customer enters account, contact, and patient information and signs the application. A qualified health care professional completes and signs the medical section.
- Do I need a notary for the Residential Medical Discount application?
- No. This application is signed without a notary; the customer and qualified health care professional sign and date their sections.
- How do I submit the Residential Medical Discount application?
- Mail the completed application with original signatures to Lodi Electric Utility, Attn: Medical Discount, 1331 S Ham Lane, Lodi, CA 95242. Faxed and emailed applications are not accepted.
Need something notarized?
This Residential Medical Discount Program Application doesn’t need a notary — but if you have another Lodi form that does, a commissioned online notary can help.