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CPS Energy Critical Care Program Application

CPS Energy, San Antonio's municipal utility, gives customers extra time to pay their bills when they or a dependent at home need electric-powered medical equipment to sustain life, or electric heating or cooling to prevent serious deterioration of a medical condition. The attending physician completes Part B, certifying that the patient requires medical equipment at the address. The physician's office must fax the application to CPS Energy.

Who completes it

The account holder completes Part A: account number, contact details, the patient's relationship to the account holder and current address. The attending physician completes Part B: patient name and date of birth, physician name, phone and address, and the signed certification.

Submitting and payment

How to submit it
The physician's office faxes the application to CPS Energy; customers can also bring supporting documentation to a CPS Energy Customer Service Center and apply in person.
Who pays
The application lists no fee for the physician's certification.

Good to know

  • A renewed application from the attending physician is required every 24 months if the patient still needs service, and the household must re-enroll when the patient moves.
  • Acceptance does not prevent disconnection for nonpayment, guarantee uninterrupted power, or guarantee restoration times.
  • Acceptance authorizes CPS Energy to share names, address and phone with City of San Antonio emergency personnel during emergencies when it interrupts service.
  • As a municipal utility, CPS Energy uses its own form rather than the Public Utility Commission of Texas critical care form. English and Spanish are in one PDF.

Get the official form

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

Residential Critical Care Program Application

Solicitud del Programa de Cuidados Críticos

Official pagePDF

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.

See how Vero Documents works

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

Can the patient submit the CPS Energy Critical Care application?

The form states the application must be faxed by the physician's office to CPS Energy, and that Part B must be completed by a physician and submitted from the physician's office. CPS Energy's page also lets customers bring supporting documentation to a Customer Service Center.

How often must CPS Energy Critical Care be renewed?

Every 24 months, with a renewed application from the attending physician, if the patient needs electric service beyond the initial 24 months. The customer must also re-enroll whenever the patient moves to a new residence.