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Requst Appointment for Energy Assistance

We are now scheduling appointments for Energy Assistance customers, on Wednesdays only. If you need assistance but your schedule does not allow you to make a drop-in visit on a weekday, you may use the form below to request an appointment on a Wednesday morning or afternoon.

Appointments are ONLY available on Wednesdays. Customers are still served on a drop-in, first-come-first-served basis on Monday, Tuesday, Thursday and Friday.

IMPORTANT NOTE: Only households with an elderly or disabled individual will be scheduled for October. We will not begin scheduling November appointments, for households without an elderly or disabled individual, until October 13th.

Fields marked with * are required.

*First Name:
*Last Name:
*Address 1:
  Address 2:
*City:
*ZIP Code:
*Primary Phone:   Include area code
  Other Phone:   Include area code
*E-mail Address:
*Time Preference:
*Office Preference:
  Check this box if there is an elderly or disabled person in the household.
  Additional information or requests regarding your appointment request:
  
    

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