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Submit your application to register life support equipment

All you need handy is your completed form - printed, signed and scanned, ready to upload.

Don't forget a medical specialist must also complete part of the form and confirm the equipment required. We'll pass these details on to Western Power so they can take in to account your particular needs in the event of a power outage.

All fields required unless indicated as optional.

Download Life Support Registration form (PDF 56KB)

Upload Application Form

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