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get an application

Good choice. Congratulations on taking the first step to better communication. To get started, just complete the application and certification form.


Request Application by Mail

To get an application packet in the mail, along with our Product Guide, click here:
Request Application

View Application on Website

To view the application and certification, you can download and print the forms at home by clicking here:
Download Application (PDF)

Important:


To be eligible, you must complete BOTH the application and the certification. After you complete the application form, turn it over and have the certification completed by a professional. Simply take the form to a professional who can certify your disability. Then send in the application and certification form with a copy of your South Carolina ID and a copy of a page from your phone bill.

Questions?
Contact us if you have any questions, or find answers to Popular Questions conveniently on our website.

To review the application process, please check out the Steps to Apply.

To find a professional certifier, you can search our Provider Network.

1401 Main St. Suite 825, Columbia, SC 29201

  • Toll free: 877.225.8337 (Voice) | 877.889.8337 (TTY)
  • Local: 803.737.0808 (Voice) | 803.737.0846 (TTY)
  • Fax: 803.737.0842
  • Email: AmplifyLife@regstaff.sc.gov