ISB Resources

• Medical Facility Request Form – This is the form Medical Providers use to request an interpreter. Please make sure the first three sections are completely filled out before submitting the request to PFP ISB.
  • Microsoft Word (doc)
  • Adobe Acrobat (pdf)
  
  
• Medical Facility Routine Request Form – This is the form Medical Providers use for recurring (routine) appointments. “Routine” is the term used by PFP ISB for appointments that recur on the same day of the week and at the same time each day.
  • Microsoft Word (doc)
  • Adobe Acrobat (pdf)
  
  
• Service Concern Form
  • Microsoft Word (doc)
  • Adobe Acrobat (pdf)
  
  

• DSHS Administration Request Form – This is the form DSHS staff persons use to request an interpreter. Please make sure the first four sections are completely filled out before submitting the request to PFP ISB.
  • Microsoft Word (doc)
  • Adobe Acrobat (pdf)
  
  
• DSHS Administration Routine Request Form – This is the form DSHS staff persons use for recurring (routine) appointments. “Routine” is the term used by PFP ISB for appointments that recur on the same day of the week and at the same time each day.
  • Microsoft Word (doc)
  • Adobe Acrobat (pdf)
  
  

Resources and Links for Requesters

• Department of Health and Human Services- Office for Civil Rights
• Department of Justice- Civil Rights Division

• Fact Sheet- Prepared by DSHS, this fact sheet provides a general overview of the ISB Program.
• DSHS Numbered Memorandum 04-57
• DSHS HRSA Interpreter Services