Client Information Form

QTF Interior Banner 3 Mobile - Client Information Form - Full Funding Packet

Client Information Form

We understand you are interested in determining if insurance will cover a QuickTalker Freestyle communication device. AbleNet’s staff of medical benefits analysts will contact your insurance company and discuss the possibility of coverage for the QuickTalker Freestyle communication device. The medical benefits analyst will let you know within 1-business day whether the device is a covered benefit under your current insurance package.

Download the Medical Release for your client to sign. You will need to submit your client’s insurance card(s). You can submit the card(s) using this secure link now or this link will be available after you submit this form.


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