Funding Documents

Congratulations on identifying a good candidate for a Lingraphica device! These forms are needed for funding sources such as Medicare and most commercial insurances.

Please note: You must be on a desktop or laptop to download, complete, and sign these forms. You cannot complete these forms on a tablet.

Patient Documents

Contact Your Documentation Specialist

Documentation Specialist
609-269-2781 • 844-281-3754

Documentation Specialist
859-951-8184 • 844-255-9175

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