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

(877) 987-2782

Toll-Free | Customer Service

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.

Agency info

AQUA AMERICA

Provides water service in in 18 states, including some counties in Ohio.