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Language Assistance Request Form Fax to: Blue Shield Translation Liaison at (209) 371-5838 Number of pages (including cover) RE: Language Assistance Request on behalf of a Blue Shield Member. Use

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How to fill out language assistance request form

How to fill out a language assistance request form:

01

Start by obtaining the form: Language assistance request forms can usually be obtained from the organization or agency that requires them. They may be available online, at offices, or through customer service.

02

Read the instructions carefully: Before filling out the form, carefully read the provided instructions. This will ensure that you understand the purpose of the form and how to properly complete it.

03

Provide personal information: The form will typically ask for personal information such as your name, contact information, and any identification numbers that are relevant to the agency or organization you are submitting the form to.

04

Indicate the language needed: Specify the language in which you require assistance. Make sure to choose the language that you're most comfortable communicating in.

05

Explain the reason for requesting assistance: In this section, briefly explain why you need language assistance. Whether it is for a meeting, appointment, or accessing services, provide a clear explanation to help the organization understand your needs.

06

Specify the type of assistance required: The form may ask you to indicate the specific type of assistance you require. This could include interpretation services, translated documents, or a bilingual staff member.

07

Provide additional information: If there are any additional details that are relevant to your request, provide them in this section. It's essential to provide as much information as possible to ensure that your needs are properly met.

08

Sign and date the form: Once you have completed all the necessary sections, sign and date the request form to verify your submission.

09

Submitting the form: Follow the designated instructions for submitting the form. This may involve mailing it, submitting it online, or delivering it in person.

10

Who needs a language assistance request form? Individuals who have limited proficiency in the language primarily used by an organization or agency will require a language assistance request form. This form is necessary to ensure effective communication and access to services for those individuals who may face language barriers. Whether it's for healthcare, government services, legal matters, or other areas, anyone who requires language assistance should fill out this form.

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What is language assistance request form?

The language assistance request form is a document used to request language assistance services for individuals who are limited in English proficiency.

Who is required to file language assistance request form?

Anyone who is limited in English proficiency and needs language assistance services is required to file a language assistance request form.

How to fill out language assistance request form?

To fill out a language assistance request form, individuals need to provide their personal information, language assistance needs, and any other relevant details.

What is the purpose of language assistance request form?

The purpose of the language assistance request form is to ensure that individuals who are limited in English proficiency have equal access to services and information.

What information must be reported on language assistance request form?

The language assistance request form must include the individual's name, contact information, language spoken, and specific language assistance needs.

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