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Governmenthigh confidence

Kansas City Board of Public Utilities fax number

(913) 573-9070

Life Support Program

Used for: Submitting Medical/Life Support documentation (Life Support Program)

Fax destination details

Department
Life Support Program
Purpose
Submitting Medical/Life Support documentation (Life Support Program)
Form
Medical / Life Support Form — Medical / Life Support Customer Application
Address
540 Minnesota Avenue, Kansas City, KS 66101
Voice phone
(913) 573-9190

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Complete Sections 1-3; physician completes Section 2; authorization to release medical information; this application must be renewed annually; submit to Kansas City Board of Public Utilities (Life Support Program) at 540 Minnesota Avenue, Kansas City, KS 66101 or fax to 913-573-9070; email: collections@bpu.com.

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