Interpreting Enterprises Request

CALL TODAY
FOR A FREE QUOTE!

Toll-free US & Canada
Tel: 800.498.2997

Local
Tel: 831.643.1940

E-mail
services@interpretingenterprises.com

Customer Payments

We are happy to offer our customers the option of paying for services using all major credits cards. To make a credit card payment, please call our offices at

1.800.498.2997

SERVICE REQUEST INFORMATION
The information provided is solely for expediting the request process. Fill out as much or as little information you feel is necessary. We will contact you for any additional information we require. Please do not provide any personal or confidential information.

Service Request Information (Required)*
Company / Firm
*Contact Person
Email
*Telephone	Ext.
*When we call you, how should we refer to this matter?
(case name, document title, claim number, subject, name, estimate, etc.)
RUSH: Please call 800-498-2997 (Any request with less than 24 hours notice is considered a rush request.)
Attachments? Click Here (Documents, Deposition Notice, Confirmation Letter, Appointment Notice, etc.).
If you don’t receive a confirmation e-mail within one hour please call our office at 1-800-498-2997.
GENERAL TYPE OF SERVICE NEEDED
On-site Interpreting
Telephonic Interpreting (Spoken Word)
Recorded Statement
Document Translation
Audio Transcription
Other (Description)
Description
Date services are needed
Starting at	am / pm
Date not specific
Estimate only
For document translation please indicate number of pages
Translation / Interpreter needed:
FROM: English Other
TO: English Other
Language	Not listed I’m not sure

LOCATION WHERE INTERPRETER IS NEEDED
Residence
Offices
Courthouse
Other
Address
Address 2
City
State
Zip
Telephone

ADDITIONAL INFORMATION (OPTIONAL)
Other information (Adjuster’s contact info., Subject matter, Courthouse Dept., Billing instructions, Comments, etc.)

BILLING INFORMATION
Name/Carrier
Address
Address 2
City
State
Zip
Telephone
Claim number
DOL/DOI