If you are a business, agency, or other group requesting interpreter services, please click here.

Part B Interpreter Request Form (Individuals)

This form is for Deaf or Hard of Hearing individuals seeking interpreting services through Federal Part B funding. 

Your Name:
Your Email:
Your Phone/TTY #:
Your Address:
I am:

Deaf
Deaf-Blind
Hard of Hearing
Late Deafened
Hearing

Type of Event: (i.e., wedding, funeral, etc.)
Day and date of Event:
Start and end time:
Address of Event:
I need: ASL Interperter
CART
Signed English Intepreter
Oral Interpreter
Other:
Interpreters you prefer:
Interpreters you do not prefer:
Additional Comments/Info:

If you do not hear from us within 24-48 hours after submitting your request, please contact us by email: referral or give us a call (603) 224-1850 ext 202 or 250

 
NDHHS :: 57 Regional Drive., Concord, NH 03301 :: 603.224.1850 :: TTY 603.224.0691 :: info@ndhhs.org