Life Support Registration Form
If someone in your household requires electrical life-sustaining medical equipment, please complete the life support registration form with your health care provider's signature and return to MLEC.
The Life Support Registration is valid for 6 months and can be renewed. As a member requiring electrical life-sustaining medical equipment and registered with MLEC, we will notify you in advance of any planned outages.
MLEC cannot guarantee electrical service to you at all times as our system can have outages caused by weather or equipment failures, so we recommend you have a plan for an outage situation.
To print this form: Click the Pop-out button in the upper right corner of the form, then the Printer at the top of the page.