CapTel Phone at No Cost
Individuals with hearing loss may receive an Internet-based CapTel phone at no cost if they complete and submit a Third Party Certification of Eligibility. Certification must be signed by a hearing health professional, such as a doctor or audiologist, who confirms that the person has a hearing loss and requires CapTel Captioned Telephone Service in order to communicate effectively over the phone.
Not able to visit your doctor’s office? No worries.
You can fill out the form and provide it to your doctor – either by email, by fax, or via U.S. Mail. Many offices can even certify your form electronically. You do not need to schedule an office visit to receive certification.
Directions
Step 1
Complete the Third Party Certification Form – by filling it out online or downloading the file and then saving it to send electronically, or by printing the form out to complete it in writing.
Step 2
Have the form signed & dated by a hearing professional as listed below. You can email, fax, or mail the completed form to your doctor for signature. Check with your doctor’s office for the correct contact information.
Step 3
Return the signed form to CapTel by:
- Fax: 1-608-238-3008
- Email: register@captel.com
- U.S. Mail: 450 Science Drive, Madison, WI 53711
- Or give to your local Outreach Educator. (Find Local Outreach Educator)
Note: Your doctor may be able to submit your form electronically on your behalf.
Fax the completed certification form to: 1-608-238-3008 or email to: Register@CapTel.com
Once we receive your signed certification form, we will contact you to arrange for free delivery or on-site installation.
Professionals qualified to sign the Third Party Certification:
Audiologists
Doctors (with a hearing-related specialty)
Primary Physician
General Practice Physician
Ear Nose Throat (ENT) Doctor
Geriatric Practice
Nurse
Hearing Related Professionals
Hearing Instrument Specialists
Veterans Service Officer
Speech Language Pathologist
Social Worker

Alternatively, your state may offer a special program that provides a CapTel phone at no cost to qualified individuals. See equipment distribution programs available in your state: State Programs
