Use this document to request a medical delay of water shutoff. This form must be completed by your physician, nurse practitioner, or a physician’s assistant.
| Name | Description | Released | Format |
|---|---|---|---|
| Name: Medical Certification Form PDF | Description: This form must be completed by a physician, nurse practitioner or physician’s assistant for customers who must maintain water service due to a medical emergency. | Released: December 12, 2023 | Format: |
| Name: Formulario de certificación médica PDF | Description: Este formulario debe ser completado por un médico, enfermero practicante o asistente médico para clientes que deben mantener el servicio de acueductos debido a una emergencia médica. | Released: December 19, 2023 | Format: |