Customer Care - The United Illuminating Company 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the patient's name and UI account number in the designated fields. Ensure accuracy as this information is crucial for processing.
3. Select the appropriate illness classification by checking either 'Serious Illness' or 'Life Threatening'. This selection determines the protection from service shutoff.
4. Indicate if the life-threatening situation requires electrically operated equipment by selecting 'Yes' or 'No'.
5. Choose the length of the serious or life-threatening situation from the options provided, ensuring you select one that accurately reflects your patient's condition.
6. Complete the physician certification section by filling in your name, address, telephone number, fax number, state license number, and signing with the date.
7. Finally, review all entered information for accuracy before submitting. Return the completed form via fax or mail to United Illuminating within seven days.

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