Get help in your language! A qualified interpreter is someone with special training for repeating what you and your doctor say to each other in the languages you both understand. Health Plan provides interpreters in your preferred language, including sign languages. This help is free for you 24 hours, every day of the year, either through phone, video, or onsite interpreters. Phone and video interpreting are available on demand and are recommended for the majority of visits. You do not need to request these services through Health Plan in advance. Onsite interpreting is also available upon request and recommended for more complex visits. This form is for requesting an onsite interpreter or an interpreter for a telehealth (i.e., Zoom) appointment.

Health Plan Member ID Number

Explain

Please scroll down, fill out the form below, and click submit. Customer Service will contact you if more details are needed.

Note: This service is available for Health Plan members. If you need help enrolling in health coverage, click here.

Member Information

First and Last Name

Phone Number

Best email to contact

Parent/Guardian Name

Parent/Guardian taking member to appointment

Address

City

Zip Code

Appointment/Provider Information

Name of Doctor or Practice

Address

City

Zip Code

Explain Other Specialty

Reachable Provider Staff Name

Phone Number

Location Details/Notes

Appointment information

Date of your Appointment

Time of your Appointment

Please Note: Requests for less commonly needed languages and sign language should be made with 10+ business days before the appointment date.

Language/Interpreter Information

Other Language Needed

Do you have a preference in gender for the interpreter you will be provided?

Other Request Details

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