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Get the free Medically Essential Electric Service Certification Form - JEA

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LIFESUSTAINING EQUIPMENT CERTIFICATION FORM MUST BE RETURNED WITHIN 15 DAYS. PARTS 13 MUST BE COMPLETED FOR THE APPLICATION TO BE APPROVED. 1. CUSTOMER/PATIENT INFORMATION (REQUIRED FROM CUSTOMER)
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How to fill out medically essential electric service

01
Step 1: Obtain the necessary documentation from your healthcare provider stating that you require medically essential electric service.
02
Step 2: Contact your electricity provider and inform them of your need for medically essential electric service.
03
Step 3: Provide the documentation from your healthcare provider to your electricity provider as proof of your medical condition.
04
Step 4: Fill out any required forms or applications provided by your electricity provider to officially request medically essential electric service.
05
Step 5: Follow up with your electricity provider to ensure that your request has been processed and that you have been granted medically essential electric service.

Who needs medically essential electric service?

01
Individuals who have a medical condition that requires the use of electrically powered medical equipment or devices.
02
Individuals who rely on electrically powered medical devices for their daily living and health needs.
03
Individuals who have a documented need for uninterrupted electric service due to a serious medical condition.
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Medically essential electric service is a service that is necessary for individuals with medical conditions that require electricity to power life-saving devices or equipment.
Individuals who rely on electric service for medical conditions and require uninterrupted power supply are required to file for medically essential electric service.
To fill out medically essential electric service, individuals need to provide documentation of their medical condition and equipment that requires electricity, along with contact information and specific power needs.
The purpose of medically essential electric service is to ensure that individuals with medical conditions have access to electricity necessary to power life-saving devices and equipment in case of power outages or interruptions.
Information required to be reported on medically essential electric service includes medical condition, equipment that requires electricity, specific power needs, contact information, and supporting documentation.
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