Use this form to refer a patient to ClearCaptions. If you’d prefer to download a form to mail, scroll to the bottom of the page for a link to download the form.
As a health provider, you are recommending your patient for ClearCaptions’ IP CTS service, based on their hearing loss and need for captions to use the phone.
ClearCaptions is available in the United States and its territories only. FEDERAL LAW PROHIBITS ANYONE BUT REGISTERED USERS WITH HEARING LOSS FROM USING INTERNET PROTOCOL (IP) CAPTIONED TELEPHONES WITH THE CAPTIONS TURNED ON. IP Captioned Telephone Service may use a live operator. The operator generates captions of what the other party to the call says. These captions are then sent to your phone. There is a cost for each minute of captions generated, paid from a federally administered fund. No costs are passed along to individuals who qualify for the service.
Overview
Resources
About us
ClearCaptions is available in the United States and its territories only. FEDERAL LAW PROHIBITS ANYONE BUT REGISTERED USERS WITH HEARING LOSS FROM USING INTERNET PROTOCOL (IP) CAPTIONED TELEPHONES WITH THE CAPTIONS TURNED ON. IP Captioned Telephone Service may use a live operator. The operator generates captions of what the other party to the call says. These captions are then sent to your phone. There is a cost for each minute of captions generated, paid from a federally administered fund. No costs are passed along to individuals who qualify for the service.
Overview
Resources
About us
