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Life-Sustaining Devices

Do you have medical equipment that utilizes electricity in use at your home? If so, we'd like to know. CEC will attempt to give those members advance notice of any planned outages and priority in the restoration of electric service whenever reasonably possible. Please note that this does not guarantee that your electric service will not be interrupted.

To be included, please complete the form below and return it to the Cooperative along with your doctor's certification. Your account must also be kept up to date so that service is not disconnected for non-payment. An application must be completed each year (CEC will send you a reminder and a new form).

The possibility does exist that you may be without electric service for an extended period when there is major damage to the electrical system. For this situation, you may want to obtain an alternate power source such as a generator or be prepared to relocate until power can be restored.

Life-Sustaining Devices

Account Name
Address
City, State, Zip
Telephone No(s) Account No.
Type of Equipment
Is Backup Available? Length of time backup can be used: _______ hours
Patient Name
Customer Relationship to Patient

-Please Complete all Portions and Attach Doctor Certification-