VOIP 911 Authorization

Please fill out the form below.

VOIP 911 Authorization

I certify that the below address is my 911 address and therefore authorize Mid-Hudson CableVision, Inc. to manually enter this information onto my account for 911 validation. I also understand that it is my responsibility to update Mid-Hudson Cablevision, Inc. of any location changes that need to be made due to the cable phone being moved to a different physical location. I also understand that Mid-Hudson Cablevision, Inc. assumes no responsibility for inaccurate information that I have provided below.

You may also download the 911 Authorization Form and mail/fax to us.

Your Name (required)

Your Email (required)

Cable Phone Number (required)

Address (required)

City (required)

State (required)

Zip (required)