Telephone Accessibility Name First Last PhoneWhat is the best time and manner to contact you? Briefly describe the disability of the member of your household, and how it is affecting his or her use of our services:Please check the service(s) with which your household member is experiencing difficulty due to his or her disability. Local calls Call waiting Call forwarding Caller id Repeat dialing Long distance toll calls Speed dialing Directory assistance Call tracing Voicemail Are you aware of any devices or services that could help alleviate these difficulties? May we contact you further about accessibility issues? Please select yes or no.YesNo
