Service Accessibility Survey – South Central Communications Is Now SC Broadband

Name*

First Last

Email*

Enter Email Confirm Email

Phone*

Address*

Street Address Address Line 2 City State ZIP Code

Briefly describe the disability of the member of your household, and how it is affecting his or her use of our services.*

Please check the service(s) with which your household member is experiencing difficulty due to his or her disability.

Are you aware of any devices or services that could help alleviate these difficulties?*

May we contact you further about accessibility issues?*

Yes
No

What is the best day to contact you?*

Note: Our days/hours for this support are Monday - Friday between 8:30am - 11:30am and 1pm - 5:00pm

Please only choose between these specific days/hours.

What is the best time to contact you?*

Choose a time frame convenient for you that we should call between.

Are you a human?