State law prevents utilities from disconnecting a consumer's electric and natural gas services for nonpayment if a permanent member of the household has a medical condition defined as "especially dangerous" to health and the consumer has a medical certification waiver on file to that effect with the utility company. 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 that 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 fax or mail the completed form to the utility company. The responsibility for determining whether a condition warrants a medical certification lies exclusively with the medical professional - not the utility or the Office of the Ohio Consumers' Counsel (OCC). This determination is made by the doctor consulting with the patient. There are no income guidelines associated with the use of a medical certification waiver. The waiver can be used for either electric or natural gas utilities or both. Investor-owned water companies also offer medical certification waivers. For more details contact the OCC.