Request An Interpreter (Non-Spanish)

Please fill out the form below to request an interpreter for languages other than Spanish, for non-clinic needs. Clinic requests automatically notify the department via EPIC.

Notify Ronda Rankin (ext. 5417) or Alicia Roeth (ext. 5427) immediately if an appointment is postponed or canceled. If we give 24-hour notice, we avoid a 2-hour minimum interpreter charge. Thank you!

Today's Date*

MM slash DD slash YYYY
Language Needed*
If Other, please specify
Date Services Needed*

MM slash DD slash YYYY
Start Time of Service*

:
Hours

Minutes

AM/PM
End Time of Service*

:
Hours

Minutes

AM/PM
Where should the interpreter meet the patient/family?*
Patient's Name*

First

Last
Patient's Date of Birth*

MM slash DD slash YYYY
Patient's Medical Record Number*
Parent or Caregiver Name*

First

Last
Parent or Caregiver Phone Number*
What is the patient coming in for?*
Who is the surgeon or physician?*
Department Information
Department (example CARES, NICU, Hosp 4 floor, etc.)*
Contact Person (full name)*
Contact Person's Email*
Contact Phone*

Primary Care

Virtual Visits

The Child Health Research Institute

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Request An Interpreter (Non-Spanish)

Notify Ronda Rankin (ext. 5417) or Alicia Roeth (ext. 5427) immediately if an appointment is postponed or canceled. If we give 24-hour notice, we avoid a 2-hour minimum interpreter charge. Thank you!

Department Information

Give Feedback

Primary Care

Virtual Visits

The Child Health Research Institute

Research Facility Opportunities

Embrace Our Passion, Advance Your Career

**Notify Ronda Rankin (ext. 5417) or Alicia Roeth (ext. 5427) immediately if an appointment is postponed or canceled. If we give 24-hour notice, we avoid a 2-hour minimum interpreter charge. Thank you!**

Department Information

Give Feedback

Search the Children's Nebraska Website

Notify Ronda Rankin (ext. 5417) or Alicia Roeth (ext. 5427) immediately if an appointment is postponed or canceled. If we give 24-hour notice, we avoid a 2-hour minimum interpreter charge. Thank you!