Medical Certification Form

Please note that if you suffer from a medical condition that could be aggravated by a lack of electricity to your home it is critical that you fill out a Medical Certification form every year for your Jay County REMC file. If you are in need of this form please click the link below, print the form, have your doctor fill it out, and you can either mail it back to us or drop it off at 484 S. 200 W. Portland, IN on Monday through Friday from 8:00am - 4:00pm.

If you wish to mail the form in please send it to:

Attn: Michelle

484 S 200 W

Portland, IN 47371

Medical Certification Form

Please note that being included on the medical priority list does NOT insure that you will be the first to have your power restored during an outage. Nor, does it prevent you from being disconnected from not paying a past due bill, however, it does give you an additional 10 days from the disconnect date to pay your bill.