Step One: Download Application Form

Download an application form and get started! For wireless devices, download an wireless application form and get started! Be sure to complete and sign your application so that you can expect a voucher or a response from us within one week. You can either print the forms and write in your information, or fill it out in your browser. Telecommunications Access Iowa (TAI) requires all original signatures on the application form.

Note: You will need an Adobe Acrobat Reader to read the application form. If you don’t have the Acrobat Reader installed, go to the Adobe Acrobat Reader website for installation. If you have any questions about the application form or need any assistance in completing it, please contact the TAI office.

Step Two: Acquire Professional Certification

A licensed professional in the field of hearing or speech will need to sign the application form to verify that you have a need for a specialized telephone, i.e., doctor, nurse, audiologist, speech pathologist, hearing aid specialist, sign language interpreter, social worker, federal/state agency representative or a teacher for the persons with hearing loss or speech difficulties.

Note: If you have received equipment from us before and wish to apply again, you may not need to have this section completed. Simply write “My hearing/speech difficulties has not changed” in the section. Be sure to include your initials.

Step Three: Choose Your Equipment

Choose the type of equipment which best meets your communication needs for telephone use. You can also receive a “package” by selecting a headset, neckloop, loud/flashing ringer, and/or amplified answering machine. You may choose up to one phone and three accessories. If you are unsure of which equipment will make telephone communication easy for you, click here to see a list of products that is offered through the TAI program and the equipment descriptions.

You may also contact any of the Dealers on the Dealer’s List for more assistance. Our showroom is available for you to visit by appointment and try out the products on display. Click here to get directions/map to our showroom. Our virtual showroom is also available for your viewing. You may also contact us.

Step Four: Send Application to TAI

Once you have completed the application form, you may send it to us in one of the following ways:

• Mail it to us at 6925 Hickman Road, Des Moines, Iowa 50322
• Scan & email it to us at info@teleiowa.com
• Your certifier also may submit the application to us via mail or email on your behalf.
• Fill it out in your browser and print it & mail it to us; or save it as PDF and email it to us.

Traditional Application		Wireless Application
Click on the form to open a PDF of the Traditional Application Form.		Click on the form to open a PDF of the Wireless Application Form.