Life Support

Notification of Installation/Removal
of Life Support Equipment

South Australians will need to fill in the following form
Please enter in your customer number, shown at the bottom of your bill.
Your National Meter Identifier (NMI) which can be found on your bill.
Personal Details
What is the physical service connection address?
Is your mailing address the same?*
Please select one below
Registration Details

Registration is available to the following life support equipment types (as specified in Section 11.1 of the SA Retail Code and Section 1.11.1.3 of the SA Distribution Code). Please indicate which type is in use at your address by ticking the appropriate box.

If the equipment is not one of the types specified it is recommended that you contact ETSA Utilities on 131261 in order to obtain a copy of the ‘Electricity and Your Life Support System' information sheet.

Medical Practitioner/Hospital Certification
Removal of Life Support Equipment
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 Practioner or Hospital that certifies my name, supply address and the fact that I require Life Support Equipment installed at the property.