Louisiana Relay: Customer Profile

1. Customer Information

Phone Number*

Additional Phone Numbers

Used by caller when contacting Louisiana Relay

Additional Phone #1

Additional Phone #2

Name*

First Name

Last Name

Address*

Address (Line 1)

Address (Line 2)

City

State

Zipcode

Email Address*

Please indicate the best way to contact you*

Phone Type

Phone

Select Phone Type

U.S. Mail

Fax Number

Fax

Provide Fax Number:

Mailing List Signup

Please include me on the Louisiana Relay mailing list.

Please include me on the Hamilton Relay mailing list.

2. Multi-User Profile/Remote Profile

Password + Personal Identification Number (PIN)

The multi-user/remote feature is of great benefit if you have more than one relay user living in your household or if you are away from your primary phone number. The Password and PIN ensures that you are the only person who can make changes to your profile. When accessing your profile from another location (remotely), please provide the CA with your 7-digit Password (alphanumeric) and 4-digit PIN (secret number) so the CA can access your profile options.

Password*

Choose 7 letters and/or numbers for Password

PIN*

Choose 4 numbers for PIN

3a. Making Relay Calls

Every time I CALL Relay, I use…

Language (select one)

English

Spanish

Call Type (select one)

Voice Carry Over (VCO) Option

Voice Carry Over (VCO)

Select VCO Option

2 Line VCO Option

2 Line VCO

Select 2 Line VCO Option

TTY

ASCII

Hearing Carry Over (HCO)

2 Line HCO

Speech-to-Speech

Voice Option

Voice only

Select Voice Option

Voice To CapTel

I am a voice user who wants to call a CapTel user.

When available, I prefer the gender of the CA relaying my call to be:

Male

Female

Either

3b. Answering Relay Calls

If you live with a person who answers Relay differently than you, skip this section.

Every time I ANSWER a Relay call, I use…

Language (select one)

English

Spanish

Call Type (select one)

Voice Carry Over (VCO) Option

Voice Carry Over (VCO)

Select VCO Option

2 Line VCO Option

2 Line VCO

Select 2 Line VCO Option

TTY

ASCII

Hearing Carry Over (HCO)

2 Line HCO

Speech-to-Speech

Voice Option

Voice only

Select Voice Option

4. For every Relay call I make, I want…

Check the service you want with EVERY relay call you make.

Relay Options:

Translation

– Translate ASL to conversational English.

Spell Check Turned Off

Relay that the CA has checked the spelling of proper names

Relay Background Noise

Relay Tone of Voice

No Abbreviations

Abbreviate Auto Message

Typing Speed Buffer

– Text appears on screen beginning at 10 wpm and may be increased in increments of 5 up to 45 words per minute.

Preferred Typing Speed

5. Speech-to-Speech (STS) Relay Connections

If you do not use STS, skip to Section 6.

6. Long Distance Company

You will not be charged for local or long distance calls. However, there are situations when payment is necessary. That includes:

International Calls
Directory Assistance
Pay Phones
Pay-Per-Call Services

Please choose your long distance company from the list provided.

My long distance company is:

7. Speed Dialing

You may save up to 50 speed dial numbers. Be sure to include the area code with the phone number.

If you are a Speech-to-Speech (STS) user, please check the box if the person is already familiar with STS.

Name	Phone Number	Familiar with STS
		STS
		STS
		STS
		STS
		STS

8. Greetings

Say First Name

I want CAs to say my first name to the people I call.

Name:

Example: “This is Louisiana Relay CA #4444 with a call from Bob.”

Tell People

I want CAs to tell the people I call that:

Tell Options

I am deaf

I am hard of hearing

I have difficulty speaking

Example: “This is Louisiana Relay CA #4444 with a call from a person who has difficulty speaking.”

Never Explain

(NE)

Never explain how to use the relay to any person I call.

Never Identify

Never identify Relay to any person I call.

(Requires “My Hello” below)

My Hello

Use “My Hello” when CAs greet me.

CAs will greet the people you call this way:

Example: “Hi, Bob here. How are you?”

9. Restrictions

If you do not want to incur extra charges to your phone bill, indicate the types of calls on the list below that you do NOT want to be placed through Relay.

900/976/800

International

Directory Assistance

Operator Assistance

10. Notes

Provide any additional call handling instructions or information for the CA here:

Notes

You’re Almost Finished!

Thank you for completing your Louisiana Relay Customer Profile. If you have any questions about your Profile, please contact Customer Care. To print a copy of this form for your records, go to the File menu of your browser and select Print before submitting the form. Your Customer Profile should be activated within 24-72 hours of receipt. All customer information is kept confidential. If you are satisfied with your Profile and ready to submit your information, click on Complete My Profile below.

Your Customer Profile should be activated within 24-72 hours from receipt. All customer information is kept confidential.

Complete My Profile

* Required information

Louisiana Relay: Customer Profile

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