HCIN Scheduled Appointment Center:

New Request

Please complete this form to request an appointment with a remote video or audio interpreter. This service is for languages of lesser diffusion, appointments that require very specific interpreter skills, or other circumstances where you want advance confirmation that the best-matched interpreter will be ready for your provider and patient. 

Important:

• This form is exclusively for use by language service managers (and their designees) at Health Care Interpreter Network member organizations.

• Scheduled appointments are billed by the hour, with a one-hour minimum charge. Late cancellations are billed for one hour.

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Instructions:

• Fill in the form as completely as you can. Do not include any patient-identifying information. Questions marked with a * must be completed. You do not need to sign in to Google.

• Find and click the red "Submit" button at the bottom. You may need to scroll the form to see it.

• Complete the Captcha security challenge (again, you may need to scroll the page to find it).

• Look for an email confirming that the request has been received (check your spam folders).
  HCIN staff will contact you when your appointment is covered, or if we need additional information.