Spanish

Submit a medical certificate from your doctor via fax, mail, or call for application assistance. Documents required: Medical certificate with the certifying Physician's or Board of Health office letter head and the following information; - Patient's name - Patient's service address - Statement that the patient resides at the premises - A statement that the disconnection of utility service will aggravate an existing medical emergency or create a medical emergency for the patient - Physician's name - Physician's business address - Physician's phone number - Physician's signature - The physician's stamp

No fee.

Lake Bluff (Green Oaks), IL
Lincolnshire, IL
Gurnee, IL
Lake Zurich (Hawthorn Woods), IL
Russell, IL
Buffalo Grove, IL
Great Lakes (North Chicago), IL
Fort Sheridan, IL
Wadsworth (Beach Park), IL
Grayslake (Gages Lake), IL
Antioch, IL
Zion (Beach Park), IL
Lake Zurich (Long Grove), IL
Waukegan (Beach Park), IL
North Chicago, IL
Round Lake (Round Lake Beach), IL
Lincolnshire (Half Day), IL
Highwood, IL
Lincolnshire (Prairie View), IL
Vernon Hills, IL
Lake Forest (Mettawa), IL
Antioch (Old Mill Creek), IL
Waukegan (Park City), IL
Lake Villa (Lindenhurst), IL
Deerfield (Bannockburn), IL
Wheeling, IL
Vernon Hills (Indian Creek), IL
Mundelein (Long Grove), IL
Fort Sheridan (Highland Park), IL
Libertyville (Green Oaks), IL
Lake Villa (Venetian Village), IL
Lake Bluff (Knollwood), IL
Libertyville (Mettawa), IL
Lake Forest (Green Oaks), IL
Deerfield (Riverwoods), IL
Grayslake (Wildwood), IL