Submit a request

Once this form is submitted, our team will review your application and be in touch.

They may require supporting documentation such as:

• a completed Electricity Authority 'Notice of Potential Medically Dependent Consumer (MDC) Status' form, which includes a certification from a DHB, private hospital or GP (accessible from their website here: Electricity Authority);

• a protection order;

• a letter from a health practitioner (e.g., a GP); or

• documentation of impairment (e.g., an ID card)