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Meter # Anderson City Utilities / Anderson Municipal Light & Power ELECTRICAL LIFE SUPPORT PROGRAM CUSTOMER DATA Part 1 Customers Name: (please type or print) DATE: Mr. Mrs. Ms. Miss Service Location:

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What is life support form?

Life support form is a document used to provide information about the medical treatment and care that an individual wishes to receive in case they are unable to communicate their preferences.

Who is required to file life support form?

Any individual who wants to specify their medical treatment preferences in case they are unable to communicate their wishes is required to file a life support form.

How to fill out life support form?

Life support form can be filled out by providing information about the medical treatments you do or do not wish to receive in case of incapacitation.

What is the purpose of life support form?

The purpose of life support form is to ensure that an individual's wishes regarding their medical treatment and care are followed in case they are unable to communicate their preferences.

What information must be reported on life support form?

Information such as preferred medical treatments, resuscitation preferences, organ donation wishes, and healthcare proxy designation must be reported on a life support form.

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