You must meet all of the eligibility criteria to participate in the Distribution Program. ORIGINAL applications must be received by KCDHH for each individual applying for equipment. To request an application to be mailed to your home click on the link below.

1. Request an application to be mailed to your address.

2. Fill out the application completely.

In order to receive your equipment faster, complete all the requested information. Fill in all the blanks on the application and answer all of the questions correctly.

3. Complete the "Professional Certification" section of the     application.

Take your application to a licensed professional who will then complete this section of the form. A licensed professional includes:

Doctors (Family or General practice or ENT only an IM    is not accepted).

Audiologists

Hearing Aid Specialists

Speech-Language Pathologists

Director of an agency serving deaf, hard of hearing    or speech impaired consumers. Verification must be    obtained from KCDHH before a Director can "certify"    applications.

Advanced Practice Registered Nurse (APRN)

4. Attach a copy of your phone bill.

In some situations, TAP must have a copy of the section of your phone bill that shows your name and address to prove you have telephone service at the address listed on your application. This is usually on the first page and is the part that you detach and send to the company when you pay your bill. If you do not have a recent bill, you may call your phone company and request a duplicate copy. 

If your name is not on the phone bill you are submitting, then you must also provide a copy of identification, such as a driver's license or other ID showing the same address as listed on your application.

For some applications, ID is required regardless of the name on the telephone bill.

5. Provide Proof of Residency.

You must prove that you have lived in Kentucky for at least one (1) year to receive equipment. To do this, answer the question on the front page of the application about how long you have lived in Kentucky and sign the "Attestment of Understanding" section of the application.

6. Equipment Selection

Pick the equipment you want to receive. Available equipment is described on the insert included with the original application. You may select one piece of telephone equipment and one signaling device. Read and select equipment carefully as it cannot be exchanged once distributed.

7. Get additional verification, if necessary.

If you are deaf, hard of hearing, speech impaired and blind/visually impaired and wish to apply for a visually assistive STE, your application will require additional certification regarding your vision impairment.  This certification can be in the form of a letter on official letterhead which includes the name, address, telephone number, license number, and signature of the licensed professional.  If you are applying for a Braillephone, you must also get certification of your ability to type and read Braille.  This can be done by an instructor of Braille. 

8. SIGN the application on the second page and mail or bring your completed application to the KCDHH office in Frankfort.

The TAP only accepts and processes original applications. Copies or faxes are not accepted.