To fill out an application from your computer, click here.
To download an application to print, click here. (This form requires the Adobe Acrobat Reader®), or you can call hawk-i Customer Service at 1-800-257-8563 and ask that an application be mailed to you.
Be sure to sign the application.
The form should be mailed to:
Imaging Center 4
PO Box 2027
Cedar Rapids, IA 52406
You can also fax the form to : 1-877-457-7701 or 1-515-457-7701.
If you do not have Adobe Acrobat Reader®, you can download it for free by clicking here.
Call us at 1-800-257-8563, Mon to Fri,
8am to 6pm
TDD: 1-515-457-8051 or 1-888-422-2319