Medical Certificate Form | Aqua America
Customers with severe health problems may have their physician or nurse practitioner submit written confirmation that the customer or someone else living at the property has a medical condition that would be aggravated if Aqua shut off the water (usually for non-payment). Once received by Aqua, a valid medical certificate gives the customer 30 days to pay the bill or to make payment arrangements.
Data provided by
211 Cleveland
Physical Address
762 W Lancaster Ave., Bryn Mawr, PA 19010
Hours
Customer service hours - M-F: 8:00am-5:00pm.
Voice
Website
Application process
Phone the toll-free Customer Service number M-F: 8:00am-5:00pm or visit the website for information and to download the Medical Certificate form (form must then either be mailed or faxed to agency - address for mail is on the website).
Fee
No fee to apply. It does not reduce the amount the household owes.
Eligibility
Serves eligible customers with severe health problems. In Geauga County, the service area is Auburn Township.
Service area
Preble County, Ohio Seneca County, Ohio Trumbull County, Ohio Auburn Township, Ohio Summit County, Ohio Marion County, Ohio Ashtabula County, Ohio Morrow County, Ohio Lake County, Ohio Franklin County, Ohio Williams County, Ohio Stark County, Ohio Lawrence County, Ohio Richland County, Ohio Pike County, Ohio Mahoning County, Ohio
Agency info
Aqua America
Provides water service in in 18 states, including some counties in Ohio.