HDSE – Request an ASL Interpreter

Request an ASL Interpreter by filling out the form below or download and save the Fillable Request Form for desktop use If you do not receive a confirming receipt of this request within 24 hours please call 814-520-8828.

Please note: if the date of your request is less than TWO BUSINESS DAYS from the date of the assignment (or from the date you will need an interpreter), please complete the form below and CALL: 814-520-8828 to ensure that an interpreter will be assigned.

*Name
*Phone
Fax
*Email
*Date(s) interpreter needed (mm/dd/yyyy)
*Day(s) of the week SundayMondayTuesdayWednesdayThursdayFridaySaturday
*Start Time (please indicate AM or PM)
*Finish Time (please indicate AM or PM)
*Purpose/Situation
*Language American Sign Language (ASL)
*Onsite Contact Name
*Onsite Contact Number
Alternate Contact Name
Alternate Contact Number
Notes
*Interpreting Location & Directions (Address, including suite #, floor, street, town, zip)
*Billing Information - Company Name
*Attention
*Address
*City, State, Zip
*Phone