Mississippi Relay



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Customer Profile Form

Please submit your customer information using the form below:
(or Click Here to Download a PDF Version)

Oklahoma Relay Customer Database Profile
Last Name
First Name, Middle Initial
Email Address
Area Code & Phone #
Street Address
City, State Zip
Caller ID Blockage (Check the box if you DO NOT want to send your phone number to a caller ID device)
Long Distance Profile
Intralata (in state) Sprint AT&T MCI Other
Interlata (out of state) Sprint AT&T MCI Other
Prefered billing method Collect

3rd Party Phone Number

Calling Card Card Phone #


Card Number
Outdial Restrictions
Long Distance Calls International 800# 900# Operator Assistance Directory Assistance
Phone Numbers Profile
Frequently Dialed Numbers Emergency Numbers
Name Number Name Number
1 1
2 2
3 3
4 4
5 5
6 Blocked Numbers
7 Call Block 1
8 Call Block 2
9 Call Block 3
10 Call Block 4
NOTE: Up to 9 characters per name Call Block 5
Answer Type TTY Voice VCO HCO

ASCII-300 ASCII-1200 ASCII-2400
Language English Spanish ASL
Customer Notes 1.

2.

3.
NOTE: Limit 76 characters per line

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