Student Concern Sheet Regarding Interpreters

* indicates required field.

Student Information:

Your Name:

* Email:

Phone:

V TTY Pager

Interpreter/Job Information:

Type of Job:
Classroom Other:

Date of Class/Job (mm/dd/yyyy):

/ /

Time of Class/Job:

Description of Job:

Course Name:

Name of Interpreter:

Concern Regarding Interpreter:

Please check all that apply.

Interpreter did not show up

There was no substitue interpreter

The interpreter was late for class

Called/E-Mailed/Paged on / /

Other:

Additional Comments:

Disability Resource Center
360 Huntington Ave
20 Dodge Hall
Boston, MA 02115

Phone:617-373-2675
TTY: 617-373-2730
Fax: 617-373-7800