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Deaf Client Feedback Form
Name
*
First
Last
Email
*
Date of interpretation:
Date Format: MM slash DD slash YYYY
The name of the interpreter:
Please Select One
Robin Anderson
Carl Boley
Lydia Harmon
Angel Kaehl
Melinda Kerr
Megan Pray
MaryAnne Thaldorf
Elise Turner
Matthew Waterhouse
Ruann Wood
View Images/Bios of Our Interpreters
Location of interpretation:
Behaviors and Attitudes of the Assigned Interpreter (Please select yes or no)
Arrived on Time
Yes
No
Dressed professionally/appropriately
Yes
No
Introduced themselves
Yes
No
Wore a VCI Badge
Yes
No
Friendly
Yes
No
Polite and respectful
Yes
No
Interpreting Skills of the Assigned Interpreter (Please select yes or no)
My interpreter had clear signs
Yes
No
My interpreter had good facial expressions
Yes
No
My interpreter interpreted everything said
Yes
No
I understood my interpreter
Yes
No
My interpreter understood me
Yes
No
Feedback for VCI:
Feedback for the Interpreter:
Your VP number:
Your text number:
Comments
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