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
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.