Medical Baseline Application

San Diego Gas & Electric is dedicated to providing safe and reliable energy to those who depend on life support equipment or have special medical conditions. The Medical Baseline Allowance Program helps customers save every month on their energy bill. Application may take up to 30 days to process.  If you have more than qualifying patient in the same household, please fill out a separate application for each person. 

Account Information
Service Address
Mailing Address
Patient Information (If you have more than one qualifying patient in the same household, please fill out a separate application for each person.)
Qualifying Medical Devices
Select all that apply.
Aerosol Tents
Air Mattress/Hospital Beds
Apnea Monitors
Breather Machines (IPPB)
Compressors/Concentrators
Continuous Positive Airway Pressure (CPAP)
Dialysis Machines
Electrostatic Nebulizers
Electric Nerve Stimulators
Hemodialysis Machines
Infusion Pumps
Inhalation Pulmonary Pressure
Iron Lungs
Left Ventricular Assist Devices (LVAD)
Lympha Press Devices
Motorized Wheelchairs
Oxygen Generators
Pacemaker Monitor/Defibrillator
Pressure Pads
Pressure Pumps
Pulse Oximeters/Monitors (must be used with other medical devices, cannot be powered by battery)
Respirators (all types)
Suction Machines
Total Artificial Heart (TAH-t)
Ultrasonic Nebulizers
The Vest/Airway Clearance System
The medical device is required for life support?
How long can the patient survive without using life support equipment? Check one.
Heating and Cooling Needs
Patient requires the Standard Medical Baseline Allowance for heating?
Patient requires the Standard Medical Baseline Allowance for cooling?

Note: While we do our best to avoid outages, we cannot guarantee that the power will always be on. Outages happen. SDG&E will attempt to notify the patient in advance of a state-directed power outage. However, if the patient requires life support equipment, he/she should make arrangements for a backup power supply in case of an outage. 

For Customers Billed By Someone Other Than SDG&E
Complex Address
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Terms and Conditions
Certification

I certify that the above information is correct. I also certify that the qualifying resident lives full-time at this address and requires or continues to require the Medical Baseline Allowance. I agree to allow SDG&E to verify this information. I also agree to promptly notify SDG&E if the qualified resident moves or the Medical Baseline Allowance is no longer needed by the resident. By signing below, I authorize SDG&E to share my customer information with other utilities and/or their agents to enable them to enroll me in other utility assistance programs.

I also authorize SDG&E to share my information regarding my participation in SDG&E’s Medical Baseline Allowance Program, including, without limitation, my name, address, contact information, circuit data, Medical Baseline Allowance Program enrollment status and medical equipment needs as described in this form if requested by emergency services professionals and agencies at the city, county, state and federal level for the purposes of managing de-energizations and to allow such parties to plan for and manage emergency situations.