Predictable & ElevenLabs FREE Voice Sign-Up Form

This form allows you to submit a request to Therapy Box for a FREE ElevenLabs Voice Clone. In order to qualify, you must have a diagnosis of MND/ALS, MSA or Mouth Cancer.

This form must be completed by a professional on your behalf.

Once you have submitted this form, the Therapy Box team will review your submission to make sure you qualify and then will be in touch through email to provide your code.

Basic Contact Information

Name

Country

Code Recipient Information

If you would like the recipient of the code to be directly included in responses, please provide their details below.

Contact Person Name

Contact Person Email

Medical Information

By tapping Submit, you confirm that the code recipient has an eligible diagnosis of ALS/MND, MSA or Mouth Cancer and are able to produce evidence of this if required.

Please check over the information you have entered before submitting. Please email our team at support@therapy-box.co.uk if you have any questions.