If the assignment is in less than 24 hours, please call our office at 516-512-6222 ext. 1.

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Requesting Customer Information

Request Details

Two hour minimum per assignment

Assignment Address

Type of Request (Check all that apply)

Initial Appointment Mental Health Appointment  Staff Meeting Multiple Deaf/HH attendees
Follow-up visit Legal Appointment One to One Meeting  Training
Medical Appointment  Educational Class Large Audience Formal event

Deaf/Hard-of-Hearing Participant's Name

Customer Billing Information

New Customers: Fill out this section completely and the office will be in contact within one business day.