Request for an Interpreter

For Missouri State University departments and organizations, please provide the following information to request an interpreter through the Disability Resource Center.

If you need an interpreter within the next 72 hours, please call 417-836-4192 and talk directly to a DRC staff member.

Please don't fill out this input box.

Your information

First name*

Last name*

Email address*

Phone number*

Description of Assignment*

Assignment information

Date of Interpreting Assignment*

Start Time*

End Time*

Is this a recurring assignment?*

If yes, list all other dates and times of the assignment.

Name of student(s) or client(s)*

Location of Assignment (Building, Room, etc.)*Be as specific as possible. Include building name, suite/room number, etc.

Does the interpreter need special qualifications such as knowledge of medical terminology?*

Required special qualifications/knowledge

Check-in contact

The check-in contact is the person who will serve as the contact for the interpreter and answer any questions.

Contact's first name*

Contact's last name*

Contact's phone number*

Billing information

Department*

Budget Contact Person*

Budget Contact Email Address*

Budget Contact Phone Number*

Budget number to charge*

Requester agreement

An interpreter cannot be guaranteed if requested with less than 72 hours notice.
Multiple interpreters may be scheduled for the assignment based on the length of the assignment and complexity of the information presented. This is determined on a case-by-case basis.
The charges for interpreting services will be billed to the budget number listed in the billing information section of this form through a budget transfer.
Cancellation of services must be received by the interpreting agency at least one full business day in advance. The DRC is not responsible for delays in transmitting a cancellation to the interpreting agency if request for cancellation is communicated through email or voice mail. By requesting interpreting services, I am responsible for notifying the DRC of a cancellation with at least 1 business day advance notice or I will be charged the full amount of the services.

Requester agreement checkbox*

By checking this box, I understand and agree to the terms of the requester agreement.