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Missouri TAP Certification Form (MoAT)

Missouri Assistive Technology's Telecommunications Access Program needs a disability certification on file before it processes applications for TAP for Telephone, TAP for Internet or the TAP Wireless Pilot. One form covers all three programs and stays valid for three years from the certifier's and applicant's signatures. TAP for Internet, for example, provides free adaptive computer equipment and training for internet and email access.

Who completes it

The applicant completes name, date of birth, last four Social Security digits, disability category (vision, hearing, speech, physical or memory/cognitive), contact details and signature. An approved certifier completes the certifier section and may use a stamp, sticker or business card for details but must sign and date by hand.

Submitting and payment

How to submit it
The applicant returns the form to MoAT's TAP office by email, fax or mail; TAP for Telephone applications are completed in person at a demo center.
Who pays
The certification form lists no fee for the certifier, and TAP for Internet supplies adaptive equipment and training free to eligible applicants.

Good to know

  • Approved certifiers include physicians (MD, DO, OD) or occupational therapists, audiologists, hearing instrument specialists or SLPs, VR or Rehabilitation Services for the Blind, Centers for Independent Living, and Special Education Directors or DMH-approved providers.
  • After three years, a new certification is needed when the applicant requests new equipment.
  • MoAT publishes the certification only as a Word document; the current version is dated July 2026.
  • TAP for Internet also requires Missouri residency, a computer and internet access at home, and household income under the program limit.

Get the official form

Download the current version from the source each time; forms change without notice.

Missouri Assistive Technology's Telecommunications Access Program (TAP) Certification Form

Official pageWord file

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How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.

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Frequently asked questions

How long is the Missouri TAP certification valid?

Three years from the date of both the certifier's and the applicant's signatures. One certification covers TAP for Telephone, TAP for Internet and the TAP Wireless Pilot. After three years, MoAT requires a new form when the person requests new equipment.

Can the certifier use a stamp on the MoAT TAP form?

Yes, for the details. Certifiers may handwrite their name, business and address, or use an office stamp, sticker or business card. The signature and date, however, must be written by hand on the form.

Who can certify for Missouri TAP?

A physician (MD, DO or OD) or occupational therapist; an audiologist, hearing instrument specialist or speech-language pathologist; Vocational Rehabilitation or Rehabilitation Services for the Blind; a Center for Independent Living; a Missouri Special Education Director or Department of Mental Health approved provider; or TAP or a TAP-approved agency.