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Upload your client’s face sheet
Thank you for considering a Lingraphica communication device, also known as a speech-generating device. To begin a free, no-obligation device trial with your client please upload a scan of your client’s face sheet and insurance cards. Please make sure the images or files are legible to ensure fast processing. We also ask that you include a photo or scan of your client’s insurance card(s).
If you have any questions, please call us at 866-330-5958.
If you have any questions, please call us at 866-330-5958.
Complete the form below to get started
Please ensure all patient information,including speech and medical diagnoses and insurance information, is legible and accurate. Inaccurate information will result in delays in your request.
Fax number for supporting documentation: 844-357-1905
PLEASE NOTE: If you’ll be working with your client for less than a week, please contact our team at 866-330-5958 to ensure your request is processed quickly.
To prevent delays in processing your request, please make sure you have the following available to upload:
A completed and legible facesheet that includes the client’s speech and medical diagnosis and insurance information.
A clear, legible copy of the front and back of the client’s insurance card.
