Get Application - Relay Utah - Relayutah

Filling out the Application - Relay Utah - Relayutah online is an essential step for users seeking assistance with communication devices. This guide will provide you with step-by-step instructions to ensure a smooth and efficient application process.

Follow the steps to complete your application successfully.

1. Click the ‘Get Form’ button to obtain the form and open it in a suitable editor.
2. Begin by entering your personal information in the specified fields. This includes your full name, area code and phone number, alternative phone number, and date of birth. Ensure you print this information legibly.
3. Provide your complete street address, including apartment number if applicable, and your city, state, and zip code. If necessary, include your post office box.
4. Optionally, enter your email address for additional communication preferences.
5. Designate a contact person to assist with appointments by providing their full name, relationship to you, and phone number.
6. Select the type of phone you are interested in. Options include corded, cordless, or cell phone. Keep in mind the note regarding responsibilities for cell phone service.
7. Review the statements regarding income changes and responsibilities for the loaned device. You must acknowledge understanding by signing and dating in the designated areas.
8. Indicate whether you receive specific assistance programs by selecting 'Yes' or 'No' for each applicable item.
9. Complete the household information section by providing your total household income and total number of persons in the household.
10. Respond to the questions regarding any disabilities you may have by selecting 'Yes' or 'No'. If applicable, describe the severity of your mobility impairment.
11. Have a qualified professional complete the certification section, including their name, office address, and phone number. The professional must sign and date the form.
12. Once all the sections are completed, review the form for accuracy. You can then save changes, download, print, or share the completed form as needed.

Complete your Application - Relay Utah - Relayutah online today.