Maryland gas and electric utilities use the Public Service Commission's Form PSC-801 to delay termination when a licensed physician, certified nurse practitioner or physician assistant certifies that losing service would aggravate an existing serious illness or prevent use of life-support equipment. An optional second section lets the customer authorize release of contact information to emergency responders during weather emergencies.
The customer fills in the resident's name, address, relationship to the customer and account number. Section One is completed only by the licensed physician, CRNP or PA: the serious illness and/or life-support box, name, title, license number, office contacts and signature. The customer signs Section Two if they want it.
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Certification of Serious Illness or Life Support and/or Permission for Utility to Release Contact Information in a Weather-Related Emergency
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Section One must be completed only by a licensed physician, certified nurse practitioner or physician assistant. The clinician certifies that terminating electric and/or gas service would aggravate an existing serious illness, prevent the use of life-support equipment, or both, and provides title, license number, contact details and signature.
No. It delays termination, and the customer must enter an agreement with the utility to pay unpaid and current bills within 30 days of submitting the certificate to continue service. The customer remains responsible for the account balance.
An optional customer permission for the utility to give local, state or federal emergency responder agencies the customer's address, phone and account number in a weather-related emergency, so they can check on the customer. The clinician does not complete it, and it does not give restoration priority.