Sign Language Resources, Inc.
    Service. Quality. Support.
 

Make a Request for Interpreting Services

Hospital, Police, Fire
Emergencies

To make a request you can fill out the form below or call 845-566-7951 (see other ways to CONTACT SLR.)  Please be as descriptive as possible. The more information we have, the better we can serve you.

If this is the very first time you are requesting interpreting services from Sign Language Resources, Inc. please call and arrange for a confirmation document that will serve as the interim contract, providing a description of the particulars for the individually requested services. For services that are expected to be ongoing, a formal contract will be signed by both the requestor and SLR.

EMERGENCIES, CANCELLATIONS, or LAST MINUTE REQUESTS (less than 2 full business days) do not use this form. Please call 845-566-7951

Please complete one form for each assignment request. (*)Indicates a required field.

REQUESTOR'S INFORMATION

          Your P.O. Number*:    Today's Date*:  

          Requestor's Name*: 

          Requestor's Company or Organization Name*: 

          Phone Number*:   Ext:  Fax Number*:  

          E-Mail*:  

 

MEETING SPECIFICS  

Meeting Start Date*:  

          Meeting End Date*:  

          Frequency*:Once Daily Weekly Monthly

          Meeting start time*:   AM PM   Meeting end time*:  AM PM

          Add'l information about date/time:

Type of service needed*:  

Setting*: 

Deaf/Hard of Hearing Consumer's Name(s)*: 

          Meeting with (Names):  

Description of the event*:  

Interpreter preferences:

Meeting Street Address*:  

          Building Name or Number:

          Suite, Unit, or Room Number:

          City*:  State*:  Zip*: 

          Directions, parking, and security instructions:

On-site contact person*:  

          Phone, Cell Phone, or Pager number*:    Ext: 

 

BILLING INFORMATION

If this is the first time you are requesting services from SLR, or information has recently changed, please fill out the billing info below.

Bill To Company:

          Street Address: 

          City:  State:  Zip:  

Billing Contact Person Name:

          Phone Number:    Ext:   Fax Number:  

          E-Mail:  

 

Additional Comments:

SLR would like you to note our cancellation policy. Generally, for a one day assignment, SLR requires 3 full business days notice should you need to cancel. Otherwise SLR will invoice for the contracted time, minus any pre-negotiated travel reimbursement. Please see Cancellations For Customers for more details.

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© 2005 Sign Language Resources, Inc., (SLR)   1607 Route 300, Suite 106, Newburgh, NY 12550
 Phone 845-566-7951            Video Phone 845-566-1417            FAX 845-566-7471          General Email            Site Map
Website Designer: Deborah Greener    Last Modified: 06/01/08
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 Sign Language Interpreting Services, Nationally Certified American Sign Language Interpreters