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Application for a FREE Sorenson Videophone

Sorenson Communications provides free videophones for deaf and hard-of-hearing individuals who require video relay service to place and receive calls.

Please fill out the online application if you:

Don't have a Sorenson videophone
Are deaf or hard-of-hearing
Use American Sign Language (ASL) to communicate

If the applicant is under 18 years of age, click here. Under age applicants must have a parent or guardian print and complete the application.

Online Application Form

Please complete the entire application. Incomplete applications cannot be processed. A Sorenson VRS trainer will contact you when a videophone is ready for installation.

If you already have a Sorenson VP-200 videophone, you do not need to apply for ntouch VP. All Sorenson customers will receive ntouch VP when their area is selected for installation.

* indicates required field When is your birthday? * Under 18? First Name * Last Name * Street Address * No PO boxes.

Apt. or Suite

City * State * Zip * Email * Videophone

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TTY Number

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Pager

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AOL IM Username
Have you changed addresses in the last year?

Yes No

Can we contact you with information about Sorenson products and SVRS? *

Yes No

Please note that Sorenson videophones are only available for deaf or hard-of-hearing individuals who primarily use ASL to communicate.

Do you have a Sorenson VP-200? * Are you applying for another person? * Are you deaf or hard-of-hearing? * Is ASL your primary language? *

All Sorensons videophone requires a high-speed internet connection. If you do not have a high-speed internet connection and would like help locating an internet service provider (ISP), please click here.

What kind of internet connection do you have? * Who is your internet service provider (ISP)? *

How did you first learn about Sorenson VRS? Comments Acceptance

By clicking "Submit" below, you are acknowledging that you have received and understood the following information. You will receive a local 10-digit number for your Sorenson videophone, and Sorenson will be your default VRS provider for these numbers. These numbers will be portable to another provider. To properly route 911 calls to local emergency service providers, Sorenson must have the address where you will use your Sorenson videophone. You can update this address by contacting support. Sorenson will confirm receipt of your updated address information. Also by clicking "Submit" below, you certify that you have a medically recognized hearing or speech disability necessitating your use of TRS. Sorenson Communications has the right to refuse service.

Click to visit other Sorenson Communications websites.