New Interpreter Request Form
Interpreter Request Form
Email address *
1. Date submitting this request to Deafinitions & Interpreting LLC: *
MM
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DD
/
YYYY
2. Date interpreter is needed: *
MM
/
DD
/
YYYY
3. Start time: *
Time
:
4. Estimated end time: *
Time
:
5. Name of Deaf consumer: *
Your answer
6. Requester Information:
a. Your name: *
Your answer
b. Name of your organization: *
Your answer
c. Phone number: *
Your answer
d. Fax number: *
Your answer
e. Do you prefer a fax or email interpreter confirmation? Please provide preferred fax or email if different than above. *
7. Address/location information for assignment. Include ALL relevant arrival information (e.g. parking instructions, building description, entrance instructions, suite number, meet-up site, etc.): *
Your answer
8. Onsite contact name/phone number: *
Your answer
9. Please provide assignment details below to help us match the appropriate interpreter(s) for your specific need. (More intensive and longer assignments may require 2 interpreters.) *
Your answer
10. Please email info@deafinterpreting.com with any materials pertaining to your request that will assist our interpreter(s) to prepare for the content that needs to be interpreted (agenda, previous meeting minutes, PowerPoints, training materials, etc.) *
Your answer
For New Customers:
*For new customers, an Authorization to Provide Payment form must be completed with your billing information and returned before services can be scheduled and confirmed. A copy of our Rates & Policies will also be provided for your records.*
A copy of your responses will be emailed to the address you provided.
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