Do you depend on Life Support Equipment?
We Need to know
If you or a family member depend on Life
Support Equipment, Please download and print a copy of the form attached to the
You will need to print the form and have it
signed by your Doctor.
Mail the completed form to:
Prairie Land Electric Cooperative
Attn: Life Support Form
P.O. Box 360
Norton, KS. 67654
Click Here To Download Life
This form is provided in PDF format. If you do not have the
Adobe Acrobat viewer (necessary to view PDF files), a free Adobe Acrobat
Viewer may be downloaded by visiting the Adobe Internet Site.
To get your free
copy of Adobe Acrobat Click Here