Provider Interpretation/Translation Services Request Form

Provider Interpretation/Translation Services Request Form

Please utilize the below form to request interpretation/translation services as needed for participant(s) in your program.

Provider Information

Provider Name*

Select

Program Name*

Select

Name of employee requesting services*

Employee Title*

Email Address*

Language Interpretation/Translation Services

Please utilize the section below to request translation/interpretation services for a participant(s) in your program.

Are translation or interpretation services needed?*

If this question does not apply to your request, please indicate "N/A"

Select

If an interpreter is needed, please indicate the language(s) in which services are needed.*

*Please allow a 5-7 business day turnaround time for interpretation requests. If this question does not apply to your request, please indicate "N/A"

Select

If the option "Other" was selected for the question above, please indicate what language(s) interpretation services are needed.*

If this question does not apply, please indicate "N/A".

If an interpreter is needed, please indicate the date that the interpreter is needed.

If an interpreter is needed, please indicate the time that the interpreter is needed.*

If this question does not apply to your request, please indicate "N/A".

If an interpreter is needed, please indicate how many hours the interpreter is needed.*

If this question does not apply to your request, please indicate "N/A".

If an interpreter is needed, please provide the address to the site in which the interpreter is needed.*

If this question does not apply to your request, please indicate "N/A".

How many interpreters are needed?*

If this question does not apply to your request, please indicate "N/A".

If translation services are needed, please indicate which document(s) need to be translated.*

If this question does not apply to your request, please indicate "N/A".

Please indicate the language(s) needed for the document(s) that require translation.*

If this question does not apply to your request, please indicate "N/A"

Select or enter value

If the option "Other" was selected for the question above, please indicate what language(s) translation services are needed.*

If this question does not apply, please indicate "N/A".

Please indicate the date that the document(s) are needed.

*Please note that there is a 5-7 business day turnaround time to receive translated documents back from TCP. If this question does not apply to your request, please indicate "N/A"

Please upload the document(s) that are in need of translation.

Drag and drop files here or

Sign Language Services

Please utilize the section below to request sign language services for a participant(s) in your program.

Are sign language services needed?*

Select

How many sign language interpreters are needed?*

If this question does not apply to your request, please indicate "N/A"

Please indicate the language(s) needed for sign language interpretation.*

If this question does not apply to your request, please indicate "N/A"

Select or enter value

If the option "Other" was selected for the question above, please indicate what language(s) sign language services are needed.*

If this question does not apply, please indicate "N/A".

Please indicate the date that sign language services are needed*

If this question does not apply to your request, please indicate "N/A"

Tactile Services

Please utilize the section below to request tactile services for a participant(s) in your program.

Are tactile services needed?*

Select

Please indicate the language needed for tactile services*

Select or enter value

If the option "Other" was selected for the question above, please indicate what language(s) tactile services are needed.*

If this question does not apply, please indicate "N/A".

Please indicate the date that tactile services are needed.*

If this question does not apply to your request, please indicate "N/A"

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