1) Click on the specifically desired device below for an application.
2) Print the application.
(If you are not able to print the application, follow instructions at the
bottom of page.)
3) Fill out the entire application clearly.
a) Attach an audiogram with the signature of a physician or audiologist
verifying your hearing loss OR
b) Have your physician or audiologist sign the application verifying your
5) Send the completed application to DDHH.
Division of the Deaf and Hard of Hearing
ATT: Equipment Distribution Program
Trenton, NJ 08625
To find out if you qualify and are eligible for equipment from the DDHH Equipment Distribution Program, click Eligibility.
To obtain an application for a specific device, click Application.
If you are not able to print the application, click "E-mail Us" and request the application in "Your Comments" box. Be sure and provide all other necessary information. Or you can call DDHH at
800-792-8339 V/TTY toll free in New Jersey;
866-642-3314 VP (Video Phone).