First Name
Last Name
Email
Phone Number
Company
Job Title
Country United States Canada Other
Industry 911 / Public Safety Banking Education Finance Government Healthcare Health_Insurance International Legal Other Insurance Retail Travel Utilities
Other Industry
Which services are you interested in? Phone/Video Interpretation Translation & Localization Both Interpretation & Translation (including on-site) Something else (detail in comments)
Do you currently use any language services? If so, what services, and how much usage per month (e.g., 1,000 min/per month of phone interpretation)?
Which translation services are you interested in? Document translationBraille, large print, 508 remediation, or readabilitySubtitles, closed captioning, or voiceover for videoseLearning, website or software localizationOther
What type of interpretation are you looking for? Phone/Audio-onlyVideoTelehealth/teleconferenceIn-person
Do you have an immediate need? Yes No
Date of appointment
Which languages do you most frequently need interpretation for?
Do you need interpretation for one or multiple locations? One locationMultiple locations
If you need onsite interpretation, which languages and locations?
How do you currently handle LEP clients?
Are you part of a Group Purchasing Organization such as Vizient or Healthtrust? (Not sure? Choose that option from the dropdown and enter your facility's address so we can look it up) Yes No Not sure
GPO and GPO ID number (if known)
Facility's street address
Facility's city
Facility's state
Facility's zip code
Comments