Round 2 COVID-19 Telehealth Program – Additional Information Collection

On June 29, 2021, the Federal Communications Commission’s (FCC’s) Wireline Competition Bureau (WCB) issued a Waiver Order to provide relief to Round 2 COVID-19 Telehealth Program applicants who (1) began and saved an application by noon on May 6, 2021, the application filing deadline, and (2) reached out in writing to USAC or the FCC for additional time to submit their application because they were not able to successfully submit their application during the application filing window.

Your organization was provided this relief and was allowed to certify your application. USAC is currently in the process of reviewing qualifying applications as part of the initial commitment phase for Round 2 COVID-19 Telehealth Program funding and we need to collect additional information and/or verify existing information on your application. Without this, it is possible we will not be able to conduct a complete review of your application.

Please download and complete the Excel form below, which is a version of the application and is required to submit supporting information. You can visit the FCC’s Application Portal to review the information you have already provided. While you do not have to re-submit information that is already present in your application, if you do make a change on this Excel form, those changes that you make will supersede any previously entered information from the Application Portal. Any previously entered information that was not changed on the Excel form will remain the same. Once you’ve filled out and reviewed the required fields, please send to no later than September 17, 2021 along with any additional documentation needed to support your request.

(Note: your application may already be complete. If that is the case, please send an email to stating this, and we will proceed with review of your application.)

If you received an email with a link to this webpage, you were listed as either the Point of Contact or Project Manager, which can also be confirmed via the FCC’s Application Portal. It is important that either the Point of Contact or the Project Manager is the individual to send the completed Excel form to the Round 2 Application Support inbox and reference the application number in the subject line (GRA00XXXXX) so that we can verify and match the information to your application.

If you have any questions about completing this form or your application, please contact

COVID-19 Telehealth Program Additional Information Form