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Referral Form

Asking a parent or guardian to complete the initial online benefit check is the easiest way to ensure we have the correct information, including all insurance cards for the individual needing the speech device.

Complete the following web form, and we will email the parent or guardian a link to complete the online benefit check.

If the parent or guardian does not receive our email, please ask them to check their spam folder.

Once approved by insurance, ALL QuickTalker Freestyle orders ship next business day! Start a benefit check today.