Refer a Patient for Captioncall Service

Refer a Patient Online

CaptionCall’s service is available only to individuals who have a hearing loss and need telephone captioning to communicate effectively on the telephone.

"*" indicates required fields

Patient information

Patient name*

First Last

Patient email

Patient phone*

Patient address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Patient's primary language*

Patient's desired products*

Additional Contact Information (optional)

Additional Contact's Name

First Last

Additional Contact's Phone

Additional Contact's Email

Referred By

Provider Name*

First Last

Title

Email Address

Business Name (if applicable)

Phone Number

Account number/promo code

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Notes

This form is not required by the Federal Communications Commission or any other government entity

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Channel

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Landing Page

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Landing Page Group

CaptionCall and Olelo by Sorenson are available in the United States 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. The CaptionCall phone and Olelo app remain the property of Sorenson in order to provide ongoing support, service, and upgrades. Patent information:  www.Sorenson.com/Legal.