Booking form

Booking non-spoken support

Please complete the following form to request an Interpreter. Once submitted a member of the team will be in touch with you.

Company / Organisation name

Name of requester

Requester email

Requesters phone number

Patient / Deaf person name

First

Last

Hospital Number (If applicable)

PO number / Billing ref / Cost code / Budget Code

Gender of Interpreter

Date required

Start time

*Format 13:00

Duration required

*Format 02:00 (hh:mm) - Please allow for any waiting time

Language Required

Other language - please specify

Venue address/ If video interpreter required what platform?

If venue is difficult to find, please note any directions and useful landmarks. Add any links for online bookings.

Name of best contact on the day

First

Last

Contact number for best contact on the day

Out of hours contact

Please include an out of hours contact for booking from 17:30 - 08.30 Monday - Friday, weekends and bank holidays.

Is on/off site parking available

Please provide details

Public transport information

Please provide details of the closest bus / train station and the distance to your venue

Invoice Address

Please provide a postal address

Invoice email

Please provide an email address for us to send your invoice

Number of deaf attendee(s)

Total number of attendees

Patient type (If applicable)

Please specify In patient or out patient

Nature of appointment

Please clearly explain the nature of the appointment

Additional information

Please use this space to provide additional information such as: patient age and gender, other communication needs, disability / religious / cultural considerations, sensitive information, the same or preferred interpreter required for future bookings, information for the interpreter. Consent to recordings should be sought from the interpreter(s) via Sign Solutions in advance. Such recordings are likely to incur an additional fee.

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Booking form

Booking non-spoken support

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