Complete and submit this form to qualify for use of radios and custom taping services
We require that you have official certification from a health care or other
appropriate professional that you qualify for our services based on an inability
to read standard print because of any of a variety of visual, physical and/or
perceptual disabilities. After you complete and submit the electronic form below, print the completed
form, take it to your professional certifier for a signature and send it to us
in the mail.
When you request the loan of a radio receiver from Sight into Sound, you must agree to return it when you no longer have a need for it or if you intend to move out of our broadcast area.