Apply Now for your FREE California Phone

It's easy to apply for your specialized phone equipment.

Just follow these simple steps:

  1. Click on your language choice below:
    English, Español, 中文, Tiếng Việt, Hmoob, Русский
  2. Fill out the first section of the application, print, and sign.
  3. Get the application certified. In addition to
    your doctor, any of the following may
    certify your need and sign the application
    form for you:
    • Licensed Medical Doctor (MD)
    • Licensed Physician Assistant
    • Licensed Nurse Practitioner
    • Department of Rehabilitation Counselor
    • Licensed Optometrist
    • Licensed Audiologist
    • Licensed Speech-Language Pathologist
    • Superintendent/Audiologist from the California School for the Deaf Fremont/Riverside
    • Licensed Hearing Aid Dispenser

    If you don't have one of these available, we can help. Just click Certifying Agent and we'll help you find one.

Once your form has been completed and signed by a Certifying Agent, you can take it to a Service Center near you to get your new phone equipment, or mail or fax your form to our Contact Center.

If you decide to mail or fax your form to the Contact Center, you will receive your approval by mail within about one week. You then need to call the Contact Center at 1-800-806-1191 to discuss what is the best phone for you.

Have Questions?


Monday - Friday 8:00 AM - 6:00 PM

Please note that the phone number and work hours listed above are for the Call Center and not the actual Service Centers.