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* 1. Your Name:

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* 2. Your Email Address:

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* 3. Your Phone Number:

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* 4. Company/Organization:

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* 5. Date of Incident:

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* 6. Location:

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* 7. Language:

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* 8. Nature of Feedback:

  Check if applicable
Compliment
Question
Suggestion
Issue with quality of interpreter
Interpreter arrived late
Issue with quality of translation
Issue with customer service

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* 9. Questions? Comments?

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* 10. Please tell us how we can serve you better:

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* 11. Would you like to be contacted?

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