EDP Application Forms
There are five (5) application forms depending on your telephone communication needs.
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CapTel:
If you are hard of hearing and want to use a captioned telephone, CapTel is an ideal product for your need. It allows you to listen to the other person and at the same time read typed word-for-word captions of everything the other person is saying. Unlike conversational relay calls showing captions between two parties, CapTel shows captions from only one party, i.e., the person who is being called.
To apply for a FREE CapTel:
Download and print three (3) forms.
- Consumer Intake Form (rev.01/21/10)
- TEDP Certification Form (rev.2/25/11)
- CapTel Application Form (rev.10/10/10)
After you have completed the forms to the best of your ability, please return them to the office nearest you either in person, by mail or fax.
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Crystal Tone Amplified Telephone:
Designed for use by individuals who are severely hard of hearing. Most powerful amplifier available, up to 50 dB gain, screens out background noise. Extra large, high contrast dial pad for easy reading, super loud ringer (up to 100 dB) with adjustable ring pitch. Tone control amplifies and enhances the tone of incoming voice for clarity. Hearing aid compatible, audio jack for use with assistive listening devices, 10 memory buttons and 3 emergency speed-dial keys. Bright ring flasher alerts you visually to incoming calls. Outgoing volume button lets you increase the volume of your outgoing voice slightly and phone also has a built in speakerphone.
To apply for a FREE Amplified Telephone:
Download and print two (2) forms.
- Consumer Intake Form (rev.01/21/10)
- TEDP Certification Form (rev.2/25/11)
After you have completed the forms to the best of your ability, please return them to the office nearest you either in person, by mail or fax.
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TTY (TeleTYpewriter):
A text telephone which is a device that enables people who are deaf, hard of hearing, or speech-impaired to use the telephone by typing and reading messages back and forth to one another instead of talking and listening. A TTY equipped with a typewriter keyboard and LED screen is required by both the caller and the person called.
To apply for a FREE TTY:
Download and print two (2) forms.
- Consumer Intake Form (rev.01/21/10)
- TEDP Certification Form (rev.2/25/11)
After you have completed the forms to the best of your ability, please return them to the office nearest you either in person, by mail or fax.
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Simplicity Model LT Telephone Ring Signaler:
It alerts you by flashing a plugged-in lamp or Add-On Strobe. Transmits to Simplicity Remote Receiver(s).
- Plugs directly into telephone line
- Built-in outlet to flash your plugged-in lamp
- Has switch to allow lamp to be turned on and off for normal room lighting
- Transmits signal to remote receiver(s) to flash lamps in other rooms
- Flash patterns follow the ring pattern
- Can plug in the add-on strobe to flash signaler itself instead of a lamp.
To apply for a FREE Ring Signaler:
Download and print two (2) forms.
- Consumer Intake Form (rev.01/21/10)
- TEDP Certification Form (rev.2/25/11)
After you have completed the forms to the best of your ability, please return them to the office nearest you either in person, by mail or fax.
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Ameriphone Q-90 Digital TTY/VCO:
* Available for for speech-impaired consumers only.*
It is a powerful, dual-purpose TTY. Stylish, lightweight, portable and full-featured, yet easy to use. Works with many cellular phones and cordless phones (phone must have 2.5mm plug outlet). True mobility and convenience. Now you can go anywhere the conversation takes you. The stylish Q90 gives you more flexibility and mobility than ever before. It works with TTY-compatible digital cellular phones, as well as many cordless phones. The Q-90 features a built-in text answering machine with remote message retrieval. A large, two-line display makes text easier to read, while a full-size keyboard with 68 keys makes typing more natural. It has a built-in microphone for hands free voice calls (VCO). Optional speakers can be used for hearing carry over (HCO) calls. Some of the other features included are: Bright visual ring flasher announces incoming calls including incoming cell phone calls, 32K conversation and incoming message memory, Hi-Speed code sends text at twice the standard speed-type as fast as you want for quicker, more economical calls. The Ameriphone Q90 TTY/VCO can be used with Q90® mini-printer and LVD (Large Visual Display). Use it at home, office, your car - just about anywhere! Comes with A/C adapter, rechargeable batteries and 2.5mm connector cord for cell/cordless phones. (available for our Speech Impaired/Hearing-Carry-Over clients only)
To apply for a FREE Q-90 TTY/VCO:
Download and print two (2) forms.
- Consumer Intake Form (rev.01/21/10)
- TEDP Certification Form (rev.2/25/11)
After you have completed the forms to the best of your ability, please return them to the office nearest you either in person, by mail or fax.