Customer Assistance Programs Questionnaire


This questionnaire is to help determine eligibility for a CPS Energy program. Upon completion of this questionnaire, you will receive an overview of CPS Energy programs that you may apply for, along with instructions for doing so.

Please note the following:

  • Failure to provide your name and contact information will prevent CPS Energy from providing you with assistance in enrolling in the programs you may qualify for.
  • Your information will be reviewed for completeness and you will be contacted by a CPS Energy Representative either by phone, email, or regular mail with instructions for completing the enrollment process.
  • If you are filling out the questionnaire on behalf of someone else, please use your information for the “Representative” contact and fill out the remaining questions based on the primary account holder.
  • Note that responding to this questionnaire does not guarantee program enrollment, it is only for determining potential eligibility.
  • Results will appear on the screen and will be sent to CPS Energy upon selecting the "Check Now" button at the end of the questionnaire.

Go to the CPS Energy website or select this link: CPS Energy Privacy Policies to review policies regarding customer information.

Customer Assistance Program Questionnaire