Florida Power & Light customers use this two-part form to have an account designated Medically Essential Service, which brings special notices before disconnection for nonpayment and before and after hurricanes. Clinicians meet it when a patient depends on electric-powered equipment to avoid loss of life or immediate hospitalization. FPL reviews the Physician's Certificate, and an accepted certificate lasts 12 months from acceptance.
The customer, plus the patient or guardian if different, completes and signs Part A. The patient's Florida-licensed physician completes and signs Part B, the Physician's Certificate, describing the equipment, hours of use and the medical reason.
The opening instructions explain how FPL decides eligibility for Medically Essential Service designation. Part A must be completed and signed by the customer and by the patient or guardian if that is a different person. Part B is completed by the patient's physician, and the entire form, both parts together, is returned directly to FPL.
The customer enters the FPL account number, name, service address and daytime phone, the name of the person using the equipment, and the patient's physician. By signing, the customer confirms the patient is a permanent resident at the address and depends on equipment as the physician specifies, and acknowledges that FPL does not guarantee service or restoration priority. The patient or guardian also signs if different.
The physician enters their name, Florida license number, address and phone. FPL reserves the right to verify the accuracy of the certificate, so give the license number exactly as issued and a phone number where the office can be reached about the patient.
Write your name, the patient's name and the patient's place of residence in the statement. By signing, you certify that the patient is under your care, has been seen by or consulted with you within the past 12 months, and depends on electric-powered equipment that must be operated continuously or as circumstances require to avoid loss of life or serious complications requiring immediate hospitalization.
In the field marked Required, describe the medically essential equipment the patient relies on. Then enter how many hours within each 24-hour period the patient uses it. Both entries are required, and the hours figure shows FPL whether the equipment must run continuously or only as circumstances require.
In the second Required field, explain the medical condition that, in your opinion, makes continuous or specified use of the equipment necessary to avoid loss of life or serious complications requiring immediate hospitalization. Attach additional pages if necessary. This is the clinical justification FPL reviews when deciding whether the account qualifies as a Medically Essential Service customer.
Sign and date Part B. The warning states that false certification of medically essential service by a physician violates Florida's medical and osteopathic practice statutes and is grounds for discipline, penalties or enforcement. All fields in the certificate must be completed for review; a valid certificate lasts 12 months from FPL's acceptance.
Download the current version from the source each time; forms change without notice.
Medically Essential Service (Part A: Customer Application; Part B: Physician's Certificate)
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A physician duly licensed and authorized to practice medicine in Florida. The physician certifies that the patient is under their care and has been seen by or consulted with them within the past 12 months. Part B asks for the physician's license number, address and phone, and FPL reserves the right to verify the information.
If FPL accepts the certificate, it is valid for 12 months from the date of acceptance. The program does not renew automatically: the customer must reapply each year with a new application and a new Part B from the physician to keep the designation.
No. FPL states that participation does not give priority restoration after a storm, does not guarantee uninterrupted service and does not exempt the customer from paying electric bills. It provides special notices before disconnection for nonpayment and around hurricanes, plus referrals to social-service agencies, so patients still need a backup plan.