KCDHH: Communication Card

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Communication Card

Design and print your own communication card

Name & Address

First name:	Last name:
Street address:
City:	State:	Zip code:

Declaration of Communication Needs

I am:

To communicate with you, I will need:
ASL Interpreter
Oral Interpreter
Pen and Paper
Picture Card

Contact Information

Who to contact to fulfill communication needs:

Phone number:

Note: This contact should be someone who could directly fulfill your needs. For example, an interpreter agency may be able to provide you with an ASL interpreter.

In Case of Emergency

In case of emergency, please contact:
First name:	Last name:
Relationship to you:	Their phone number:

Image depiciting sample of a communication card.

After printing your communication card, cut along the outside dotted line then fold at the center dotted line for a business card sized communication card for easy storage in a wallet.

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