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Tel: 802-254-3920 (V/TTY/VP)
Toll Free: 800-639-1519 (V/TTY)
Email: VIRS@sover.net
Fax: 802-258-9564

We want to hear from you! Please let us know your interpreter preferences.

For your convenience, we have provided an online consumer profile form or you can choose to download one of the forms to mail in to:

Vermont Interpreter Referral Service
130 Austine Drive, Suite 110
Brattleboro, Vermont 05301

Click on the pdf or Word icon to download the consumer profile form (short version). (16K)

Click on the pdf or Word icon to download the consumer profile form (long version). (22K)

Our evaluation forms are in PDF and Word format. If you are unable to open the pdf, please click on the Acrobat Reader icon below to download the free plug-in for your browser. Thanks!

Required Information:
Items marked with an asterisk * must be filled in.

Consumer Profile Form:
Name:*
Email:
Pager/tty:
Videophone:
I am: Deaf Hard of hearing Late deafened Oral deaf Deaf/blind Deaf with a vision impairment Hearing but unable to speak verbally
What I want : (check all that apply) ASL Interpreter English Interpreter Oral Interpreter Deaf/blind Interpreter Deaf and vision impaired Interpreter Certified Deaf Interpreter (CDI) CART Foreign Language Interpreter

Interpreters I prefer to use: (put for what kind of special situation-such as meetings, trainings, medical situations, conferences, etc.) Put in order 1^st choice, 2^nd, etc.
Situation	Interpreter Name	Interpreter Name	Interpreter Name

Interpreters I prefer NOT to use:

Situation	Interpreter Name	Interpreter Name	Interpreter Name

CART Providers I prefer to use:

Comments:

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Site by Beth Armour

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We want to hear from you! Please let us know your interpreter preferences.

Consumer Profile Form:

I am:

What I want :

Interpreters I prefer to use:

Interpreters I prefer NOT to use:

CART Providers I prefer to use:

Comments: