CONSECUTIVE INTERPRETATION

Interpretation Service Request

PALS for Health will be in contact with you via phone and/or email within 24 hours of receiving your request. Please contact us at [email protected] or 213.553.1818 with questions.

In person appointments, there is a 2 hour minimum charge & 2 hour minimum charge for last minute cancellations less than 24 business hours.
Virtual appointments, there is a 1 hour minimum charge & 1 hour minimum charge for last minute cancellation less than 24 business hours.
Telephonic appointments, there is a 15 minute minimum charge & 15 minute minimum charge for last minute cancellation less than 24 business hours.

* Indicates required field

Organization *

Organization Other (if not listed) *

Language Requested *

Your Name *

First

Last

Your Email *

Your Phone Number *

Today's Date *

Doctor's Name *

Doctor's Telephone *

Type of Appointment *

In Person Telephonic Virtual

If virtual, please include link *

Patient's and/or Student's Name *

First

Last

Patient's and/or Student's DOB *

Patient's and/or Student's Gender *

Male Female Other

Appointment Date *

Appointment Duration *

Appointment Time *

Purpose of Appointment *

Appointment Address *

Line 1

Line 2

City

State

Zip Code

Country

Additional Comments or Questions *

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