Medical certifications can be used to prevent a utility disconnection up to three times during a 12-month period or to reconnect service if the customer has been disconnected for no more than 21 days. Certification forms must be completed for each case of disconnection or reconnection. The waiver is valid for 30 days and forms are available from the utility. The certification must be signed by a licensed physician, physician assistant, clinical nurse specialist, certified nurse practitioner, certified nurse-midwife or a local board of health physician. Generally, the medical personnel will fax or mail the completed form to the utility company.