How to Fill Out and Submit the Consumers Energy Medical Certification Form

The Consumers Energy medical certification form, officially Form 1339, is what Michigan households use to postpone a shutoff or restore service that has already been cut when a resident has a serious medical condition. You download the form, fill in your account information, have a physician or public health official certify the medical need, and send it to Consumers Energy by secure email, fax, or the online portal. Once you notify the utility that a certification is coming, it must hold any shutoff for three business days while you get the paperwork completed.¹

Where to Get Form 1339

Consumers Energy posts Form 1339 as a PDF on its website, and you can download it directly.² The utility is required to make the commission-approved form available on request, so if you can’t print it, call customer service and ask them to mail you a copy.¹

If a shutoff notice is already on your account, call Consumers Energy before you have the signed form in hand. Telling them a certification is on the way starts the three-business-day grace period that keeps your service on while you finish the paperwork.

What You Fill In

Your part of the form asks for the account holder’s name, the Consumers Energy account number, and the service address where the patient lives. You also need to submit valid identification along with the form.² Your account number is printed on your most recent bill.

What the Medical Provider Must Document

The certification has to be signed by a physician or a public health official. Nurses, physician assistants, and other staff cannot sign it in their own name.³

The provider’s section must cover three things:

The medical condition that makes uninterrupted electric or gas service necessary.
Any electrically powered medical equipment the patient depends on, such as ventilators, oxygen concentrators, dialysis machines, CPAP machines, nebulizers, infusion pumps, or powered wheelchairs.
How long a shutoff would aggravate the condition.

The provider signs and adds contact information so Consumers Energy can verify the certification. The practical options are to bring the blank form to an appointment, drop it off at the office, or ask the office to fax the signed form directly to the utility. Many clinics have handled Form 1339 before.

How to Submit the Form

Once you have the signed form and your ID, send everything to Consumers Energy through one of the channels listed on the form:²

Secure email: Medical@CMSEnergy.com
Fax: 517-325-8232
Online upload through the secure portal at ConsumersEnergy.com

Email and fax tend to move fastest. Keep a copy of what you send and note the date, in case there is any question later about when protection began. Follow up by phone a few days after submitting to confirm the form was received and the hold is on your account.

What Protection the Form Gives You

The same form covers two different protections, and the one you get depends on what the provider certifies.

For a short-term medical emergency, Consumers Energy must postpone a shutoff or restore disconnected service for 21 days from receipt of the form, and it cannot charge an after-hours reconnection fee or require a deposit to turn service back on.¹

For a condition where losing power would be immediately life-threatening or where the patient depends on life-support equipment, the account is placed on the critical care list and stays protected as long as you remain eligible and unable to pay.³ Consumers Energy confirms that critical care enrollment has to be renewed each year.⁴

Renewing and Reusing the Form

A medical emergency hold lasts 21 days per certification. If the condition continues, a new signed form resets the hold for another 21 days, up to 63 days of total protection per household member in any 12-month period. Across the whole household, Consumers Energy is not required to grant more than 126 days of medical emergency protection in a 12-month span.¹

Critical care status runs on an annual cycle instead. Consumers Energy will notify you when renewal is coming up, but mark your own calendar as a backup. If the certification lapses, the account loses its critical care flag and standard disconnection rules apply again. If the qualifying condition resolves, someone in the household has to tell the utility.³

The Bill Still Has to Be Paid

Neither protection forgives your charges or pauses billing. Michigan’s rules say directly that nothing in these provisions relieves a customer of the obligation to pay for service, and the form itself notes that approval does not prevent shutoffs indefinitely.¹² For critical care customers, Consumers Energy can require a reasonable payment plan as a condition of continued protection.³ Ask about payment plans and energy assistance when you submit the form; combining the two is what keeps service on past the certification window.⁵

1
Legal Information Institute. Michigan Code R 460.130 – Medical Emergency
2
Consumers Energy. Medical Certification Form
3
Michigan Department of Licensing and Regulatory Affairs. Michigan Administrative Code R 460.101 to R 460.169
4
Consumers Energy. Life Support
5
Consumers Energy. Payment Plans and Assistance