TEP Medical Device Alert Practitioner Certification

Tucson Electric Power flags accounts in its Medical Device Alert program when a household member uses a life-sustaining medical device or has a condition requiring continuous electric service. The practitioner's certification, attached to letterhead or a prescription form, triggers the alert. TEP then shares outage status and estimated restoration times and gives advance notice of planned outages at the residence.

Who completes it

The customer signs the Customer Authorization Form and adds the account number and an emergency contact. A licensed medical practitioner completes the certification: name, license number and expiration date, patient name and address, a statement about the device or condition and discussed contingency plans, signature and date.

Submitting and payment

How to submit it
Attach the certification to office letterhead or a prescription form and mail or email it to TEP's Medical Device Alert Program; physicians can also complete it online through TEP's provider link. Recertify every two years.
Who pays
The form lists no fee for the practitioner's certification.

Good to know

  • Incomplete documentation is returned directly to the customer, not to the practitioner's office.
  • The program is not a low-income or discount program and does not guarantee uninterrupted service; customers must stay current on their monthly bills.
  • After a move, a new practitioner certification must be approved before the alert applies to the new address.
  • A Spanish version of the brochure is available. UniSource Energy Services runs on the same UNS Energy platform.

Get the official form

Download the current version from the source each time; forms change without notice.

Medical Device Alert - Licensed Medical Practitioner Certification Form

Fill it with Vero

If your copy of the form is a fillable PDF, upload it once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.

How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.

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Frequently asked questions

How often must the TEP Medical Device Alert be renewed?

TEP requires participants to be recertified every two years. A new practitioner certification is also needed whenever the customer moves, and the alert is not placed on the new account until TEP approves it.

Does the TEP certification need to be on letterhead?

The form instructs physicians to attach it to office letterhead or a prescription form before it is mailed or emailed. Physicians can instead complete the process online. Incomplete documentation goes back to the customer, so include the license number and expiration, patient details, signature and date.

Does Medical Device Alert prevent disconnection?

No. It places an alert on the account so TEP can share outage status, restoration estimates and planned outages. TEP states it does not guarantee uninterrupted service and is not a discount program, and customers must keep paying monthly bills.