FAQs on Applying!

Have questions about applying and if you qualify?
Review the FAQs for answers.

Need help filling out your application?
Give us a call at 1-800-806-1191

There are five circular photos with yellow lines connecting five individuals. Photo descriptions from left to right: 1) A woman sitting on a couch next to a wooden table. The table has a photo, lamp and a landline telephone with enlarged dial pad. The woman has dark skin, medium length hair, is wearing a white turtleneck top and is smiling while holding the telephone to her ear. 2) A girl with fair skin and strawberry blonde medium length hair is looking up to her left, away from the camera. She is wearing a tie-dyed sweatshirt. She has a feeding tube taped on her cheek. She is holding a tablet in both of her hands. 3) A man with dark skin and shaggy medium hair is looking away from the camera to his right. He is wearing a yellow shirt, silver necklace with pendant and a cordless headset phone. 4) A woman is sitting in front of her desk with a blue wall and a frame behind her. On her desk is a landline telephone and flowers. The woman has fair skin and red hair. She is wearing a pastel peach color buttoned up shirt and a black blazer. She is holding the telephone to her ear and is smiling. 5) A man with dark skin and short hair is smiling away from the camera to his right. He is wearing glasses, an orange shirt and a plaid buttoned shirt that is left open. He also is wearing a hearing device around his neck.

Application Support

Need help filling out your application?
Give us a call at 1-800-806-1191

How to complete the Applicant Contact Information section

Contact Information

Fill out the information for the person applying to receive specialized equipment.

Upload Support Documents

Click the dropdown box and select your disability.

If you have multiple disabilities, or are unsure, select “prefer not to say” and we will refer to your supporting documentation or reach out for more information.

Disability Type

If you have acceptable documentation dated within the past two (2) years, you will not need to complete the Medical Professional Information section. This documentation must meet the following guidelines:

File Format and Size

You can upload the following types of files:

PDF
Doc
Docx

Files must be 1 MB or less.

To find the size and format of your file you can:

Windows:
- Right-click the file
- Select "Properties"
- A window will open showing information about your file
Mac
- Select the file
- Press Command + i on your keyboard
- A window will open showing information about your file

Acceptable Documentation

Your application will be considered complete without filling out the Medical Professional Information if you can upload one of the following:

Prescription
Reports including:
- Audiogram
- Vision Exam
- Health Certificate
Signed note or letter from a Medical Professional

Required Information

Your supporting documentation needs to be dated within the last two years and include a Medical Professional’s:

Full Name
Telephone Number
State license number (if applicable)

The document must also clearly indicate your disability.

Unacceptable Information

Do not include any documents that list your:

Social security number
Banking information
Credit card number

Signature of Applicant

Click the yellow box that says “click to sign” and a signature box will appear. You can type your name in or draw your signature. When you complete this, click “Adopt and Sign”.

Are you a Medical Professional

Select “No” if either of the following apply to you:

You have uploaded acceptable certifying documentation
You are not currently with a Medical Professional

Select “Yes” if you are currently with a Medical Professional.

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