Examples of circumstances when it may be necessary to provide interpreters include, but are not limited to, obtaining a Patients medical history or description of ailment; explaining or discussing a Patients diagnosis or prognosis; explaining or discussing follow-up care, including a Patient’s or Companion’s questions regarding the Patient’s condition and/or previous or future procedures, tests, and/or treatment; and medications prescribed.
In compliance with the Americans with Disabilities Act (ADA), qualified interpreters and other auxiliary aids and services are available free of charge to people who are deaf or hard-of-hearing.
These signs will include the international symbols for "interpreters” and list the name and contact information for the person(s) to whom a Patient or Companion should speak in order to request auxiliary aids or services. The signs shall also contain the following statement: “For more information about the Americans with Disabilities Act (ADA), call the Department of Justice’s toll-free ADA Information Line at 1-800-514-0301 (voice), 1-833-610-1264 (TTY) or visit the ADA Home Page at archive.ada.gov. ”
FOR PETER CHANG-SING, M.D., F.A.C.C.
Date: July 21, 2014
Date: July 22, 2014
United States Attorney
/s/ Erica Blachman Hitchings
ERICA BLACHMAN HITCHINGS
Assistant United States Attorney
/s/ P. Chang-Sing, M.D.
PETER CHANG-SING, M.D., F.A.C.C.
/s/ Mary M. Sackett
The Goldman Law Firm
Counsel to Peter Chang-Sing, M.D., F.A.C.C.
Name of Person with Disability (if not patient)
Relationship to Patient: ____________________________
Nature of Disability:
Please let us know what type of effective communication service would make your visit successful:
Please describe type of Interpreter
All Communication Services will be provided FREE OF CHARGE
We ask these questions so we may communicate effectively with you. As noted above, all communication aids and devices are provided FREE of CHARGE. If you need further assistance, please ask a member of our office staff.
Any questions? Please call our office, ______________________ (voice), __________________ (TTY), or visit us during normal business hours.