Disabled or Electricity Dependent Services Application

If you are in immediate danger please contact your local emergency services or dial 9-1-1.

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

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If you have issues with accessibility with the form email us at [email protected].