Disabled or Electricity Dependent Services Application
Individuals who complete the application below will be contacted by their local Disability Disaster Access & Resource Center (DDARC) staff and assessed for disaster and emergency services, including Public Safety Power Shutoff (PSPS) events.
Note: We are currently experiencing a high level of engagement in this program. We will be responding to applications in the order they are received. Due to the high level of interest, processing may take up to 3 weeks. We appreciate your patience.
Downloadable PDF version (English)*Updated Oct 2022
Downloadable PDF version (En Español)*Actualizado Oct 2022
Seleccione el menú desplegable de idioma en la parte superior derecha de la página para traducir el formulario incrustado.
Due to website errors, our application method has temporarily changed. If you have issues with accessibility with the form on this page, please use this redirect link or email us at [email protected]
https://docs.google.com/forms/d/e/1FAIpQLSe02AaXnC0FuvmMY7jYXb6ZXfKGIoZ1OGS0oVG8_O-M3MTtFA/viewform
English
Spanish