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Get the free Language Capability Attestation (Disclosure) Form - Valley Health Plan

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LanguageCapabilityAttestation(Disclosure)Form InAccordancewith,CaliforniaHealthandSafetyCodeSection1300.67.04oftheLanguageAssistanceProgramRegulations, Valley Health Plan (VHP) needstoidentifywithinitsprovidernetworkthosecontractedproviderswhoarethemselves bilingualorwhoemployotherbilingualprovidersand/orofficestaff,
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How to fill out language capability attestation disclosure

01
Review the language capability attestation disclosure form to understand the information required.
02
Fill out your personal information such as name, address, and contact details.
03
Indicate your proficiency level in the language(s) indicated on the form.
04
Provide any relevant supporting documents or certifications to validate your language proficiency if required.
05
Sign and date the form to attest that the information provided is accurate.

Who needs language capability attestation disclosure?

01
Individuals who are required to demonstrate their language proficiency for employment, education, or certification purposes.
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Language capability attestation disclosure is a document where individuals disclose their proficiency in a language.
Individuals who claim proficiency in a certain language may be required to file language capability attestation disclosure.
Language capability attestation disclosure can be filled out by providing honest and accurate information about one's language proficiency.
The purpose of language capability attestation disclosure is to assess individuals' language skills and determine their proficiency level.
On language capability attestation disclosure, individuals must report their proficiency level in a specific language.
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