Easy Does It Emergency Services Reduced Co-pay Application
Easy Does It Emergency Services (EDI) has a Reduced Co-pay Program to help with the cost of attendant and transportation services for low-income individuals. Those who qualify will have a co-pay of $7.50 per hour for attendant care, device repair, and emergency transportation. (The non-reduced rate is $15 per hour). Qualification is determined by federal poverty guidelines, and income verification is required.
Please note: After you've submitted this form, you must send at least one of the following forms of documentation to complete your application:
- Pay stub
- Tax return (most recent)
- Bank statement
- Proof of enrollment in Medi-Cal
- Proof of enrollment in CalWorks
- Proof of enrollment in CalFresh/SNAP/EBT
- Self-certification letter
Documentation can be sent using the following options:
Easy Does It Emergency Services
3222 Adeline St.
Berkeley, CA 94703
You may call 510-845-5513 to make arrangements to drop off your documents in person (to the address above).
If you have any questions or need assistance with any part of this process, please call EDI at 510-845-5513.
Sign in to Google
to save your progress.
Phone Number (Including area code)
Page 1 of 2
Never submit passwords through Google Forms.
This form was created inside of Easy Does It Services.