Quickly and easily complete the entire process online, including getting your doctor/professional's signature. Click below to begin your online application now.
Electrolarynx
Qualifications:
- Resident of Illinois that has had a Laryngectomy.
- Have active phone service
- Standard
- Cellular
- Pre-Paid
- Have your application signed by your Speech-Language Pathologist.
Prefer to print and mail your application?
Click Here to Download Electrolarynx Application
Click Here to Download Equipment Sheet
Speech iPad and Speech App (Loan Program Only)
Qualifications:
- Resident of Illinois with a permanent speech disability.
- Have active phone service
- Standard
- Cellular
- Pre-Paid
- Complete your application, loan agreement and have your certification signed by your Speech-Language Pathologist.
Applicant must be at least 5 years of age. Copy of birth certificate required if applicant is under 18 years old.
Prefer to print and mail your application?
Click Here to Download the iPad/iPhone Loan Application Packet
Click Here to Download Speech iPad Spec Sheet
Click Here to Download Speech App Spec Sheet
Click Here to Download Speech iPad Quick Start Guide