Private Providers - Interpreter Request

Please use this form for Interpreter bookings planned for greater than two business days in advance

If your Interpreter need is immediate or within the next two days, please call the Interpreting Booking Office on 4924 6285

Agency Information

Requesting agency *

ABN for billing purposes *

Address

Contact person *

Contact number *

Contact email address *

Name of Professional

Client Details

First name *

Last Name *

Gender

Male
Female
Either

Preferred language * Please select from the below list

Country of birth

Appointment type *

Telephone
Video
In Person

Appointment date *

Appointment time *

Appointment duration

Appointment location *

Discussion topic *

Special instructions

Authorising Person

Full Name *

Position *

Phone *

Email Address *

I Consent to the below terms *

The Authorised person has agreed to the following Rates for Provision of Services

Phone Interpreter Service	$50.00 for 1^st half hour session (plus GST)	$25.00 per additional 15mins thereafter (plus GST)
Video Conference Interpreting Service	$90.00 for 1^st hour session (plus GST)	$45.00 per additional 30mins thereafter (plus GST)
Onsite Interpreter Service	$300 for 2.5hr session (plus GST)	$60 per additional 30mins thereafter (plus GST)
Travelling Allowance	$90.00 per hour	For distances more than 50km in each direction

I acknowledge the fees charged by Health Care Interpreter Service for Interpreting bookings and undertake to pay the fees within 14 days from the invoice date.

I understand if cancellations occur on the same day of the booked time, a cancellation fee equal to the minimum fee plus GST is applicable.