Medical Interpreter and Translator Language Skills Self-Assessment Form

Instructions:
Please complete the following form and, should you have questions or wish to discuss any part of your evaluation, please contact us at 802-488-5223 or abdool@freeaccessclinic.org. When the form is completed, simply click on the “Submit” button at the bottom of the form. Thank you!

Please evaluate your language abilities for each of your target languages. For each of the skills listed below (e.g. Listening, Reading and Speaking), check only one box per category that is your best description of your present abilities.

Name
Phone
Language
Date

Understanding: Listening
Check only one box that is your best description of your present abilities







Understanding: Reading
Check only one box that is your best description of your present abilities







Speaking: Spoken Interaction
Check only one box that is your best description of your present abilities







Speaking: Spoken production
Check only one box that is your best description of your present abilities







Writing
Check only one box that is your best description of your present abilities






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Chart from: http://europass.cedefop.europa.eu/LanguageSelfAssessmentGrid/en

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