Texas Specialized Telecommunications Assistance Program
This file contains the application for the Specialized Telecommunications Assistance Program provided by Texas Health and Human Services. It is designed for residents with disabilities who require specialized telecommunications devices. The application outlines the necessary information and documentation needed for submission.
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How do I fill this out?
To fill out this application, start by providing accurate personal information in the designated fields. Then, gather and include proof of Texas residency as specified in the instructions. Lastly, select the appropriate telecommunications device based on the applicant's disability needs.

How to fill out the Texas Specialized Telecommunications Assistance Program?
1
Complete the applicant information section accurately.
2
Provide proof of Texas residency with acceptable documents.
3
Select the appropriate telecommunications device required.
4
Sign the application where indicated.
5
Submit the completed application as directed.
Who needs the Texas Specialized Telecommunications Assistance Program?
1
Texas residents with hearing impairments who need specialized devices.
2
Individuals over five years old requiring assistance with telecommunications due to a disability.
3
Guardians applying on behalf of a child or adult with disabilities.
4
Residents with mobility impairments needing accessible phone technologies.
5
Deaf individuals looking for methods to communicate effectively via phone.
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1
Open the application PDF in PrintFriendly.
2
Click on the fields to enter your information directly.
3
Make any necessary edits to your responses.
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What are the instructions for submitting this form?
To submit this form, mail it to STAP at P.O. Box 12607, Austin, TX 78711. Ensure that the application is signed and accompanied by all necessary documentation. For further assistance, you may contact ODHHS directly at their service number for guidance.
What are the important dates for this form in 2024 and 2025?
This application form is valid until August 31, 2024. Important deadlines include submitting your application before this date to ensure you receive the necessary assistance. For any application processed after this date, a new application must be filled out.

What is the purpose of this form?
The purpose of this form is to facilitate access to specialized telecommunications devices for Texas residents with disabilities. By completing this application, individuals can request assistance that will enhance their ability to communicate effectively through phone services. This program ensures that all Texans, regardless of their disability, have equal opportunities to access essential communication tools.

Tell me about this form and its components and fields line-by-line.

- 1. Applicant First Name: The first name of the applicant.
- 2. Last Name: The last name of the applicant.
- 3. Street Address: The residential address where the applicant resides.
- 4. City: The city of the applicant's residence.
- 5. State: The state where the applicant resides.
- 6. ZIP Code: The ZIP code of the applicant's address.
- 7. Home Phone No: The primary contact number for the applicant.
- 8. Birth Date: The birth date of the applicant.
- 9. Email Address: The email contact for the applicant.
What happens if I fail to submit this form?
Failure to submit this form may result in delays or denial of requested assistance. It's important to ensure all sections are completed correctly to avoid any issues. Missing information could lead to a need for re-application or additional documentation.
- Incomplete Applications: Missing fields or required signatures can lead to application rejection.
- Documentation Issues: Lack of necessary proof of residency or disability may hinder the application process.
- Deadlines: Submitting the application after the expiration date will require filing a new application.
How do I know when to use this form?

- 1. To apply for telecommunication devices: When individuals need devices that help them communicate effectively via phone.
- 2. For proof of residency: To provide necessary documentation confirming Texas residency.
- 3. When seeking assistance from STAP: To ensure that applicants receive the aid necessary for better communication.
Frequently Asked Questions
What is the purpose of this form?
This form is used to apply for the Specialized Telecommunications Assistance Program for eligible Texas residents.
Who can apply for this program?
Anyone who resides in Texas and has a disability requiring specialized telecommunications equipment can apply.
How do I know if I qualify?
Eligibility is determined by your ability to provide documentation of residency and disability.
What devices can I request?
You can request various telecommunications devices suited to different disabilities, as outlined in the application.
What documents do I need to provide?
You need to submit proof of Texas residency and any necessary documentation regarding disabilities.
Can I edit my application after filling it out?
Yes, you can easily edit your application using PrintFriendly's PDF editor.
Is it necessary to provide an original signature?
Yes, the application must include an original signature, as photocopies are not accepted.
How will I submit the completed application?
You can submit the application by mail or as directed in the submission instructions.
Can I save my edits?
You can download the edited PDF once you have completed your application.
What if I have questions while filling out the form?
Feel free to consult the instructions or seek assistance from a STAP representative if needed.