Deaf Community Member Preferences
Please fill out as much as you feel comfortable sharing. This information will be kept confidential. LIM may share some information with interpreters who will be working with you to help them do their job more successfully.
Full Name
*
First Name
Last Name
Video Phone Number
Format: (000) 000-0000.
Gender
Male
Female
Other
Text Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
E-mail
example@example.com
Educational Background?
Please Select
Deaf School (KSD/ISD, etc)
Mainstreamed
Oral School
Homeschooled
Other
Language Preferences
ASL
English Order
Oral
I prefer to speak for myself
Deaf-Blind
Please visit
http://gowithlim.com/interpreters/
to see pictures our team of interpreters.
Preferred Interpreters:
Interpreters you DO NOT want:
I prefer to work with interpreters of the same gender.. (male with male, female with female)
Yes, for all appointments.
Yes, only for medical appointments.
No, it is not important to me.
Best way to contact me is:
Please Select
VP
Text
Email
Mail
Suggestions?
How did you hear about LIM?
Will you be willing to recommend us?
Yes
Maybe
No
Would you like us to send you some of our business cards?
Yes
No
Submit
Should be Empty: