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Energy Provider, Electricity Suppliers, Gas Suppliers, Victoria (VIC), South Australia (SA)

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Notification of Installation/Removal of Life Support Equipment

Account Holder Details

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Your Customer number which can be found at the bottom of your bill near the total due.
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Your National Meter Identifier (NMI) which can be found on your bill.
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Residential (Supply) Address

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Postal Address

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Action

By completing this form you accept that:

  • Simply Energy and ETSA Utilities will share the relevant information about you and your supply address for the purposes of updating their records and registers.
  • You agree to inform Simply Energy and ETSA Utilities if the person for whom the Life Support Equipment is required vacates the supply address or no longer requires the Life Support Equipment.
  • You acknowledge that registering as a life support address does not guarantee supply and in particular your supply will still be subject to outages due to storms, accidents or other circumstances beyond ETSA's and Simply Energy's control.

I understand this request will not be processed until I send Simply Energy a certificate from my Medical Practitioner or Hospital that certifies my name, supply address and the fact that I require Life Support Equipment installed at the property