This version of the form is not currently in use and is provided for reference only. Download this version of the document for the current year.
This is a legal document that was released by the New York State Department of Health - a government authority operating within New York.
The document is provided in Arabic.
Q: What is the purpose of the Language Access Complaint Form?
A: The purpose of the Language Access Complaint Form is to report any issues related to language access services in New York.
Q: Who can use the Language Access Complaint Form?
A: Anyone who has experienced or witnessed a violation of language access rights in New York can use the Language Access Complaint Form.
Q: What does language access mean?
A: Language access refers to the right of individuals with limited English proficiency or those who are deaf or hard of hearing to have access to interpretation and translation services.
Q: What information should be included in the Language Access Complaint Form?
A: The Language Access Complaint Form typically requires information such as the date, time, and location of the incident, details of what occurred, and contact information of the complainant.
Q: What will happen after I submit the Language Access Complaint Form?
A: After submitting the Language Access Complaint Form, the organization responsible for language access services will review the complaint and investigate the reported issue.
Q: Can I remain anonymous when submitting the Language Access Complaint Form?
A: The Language Access Complaint Form may allow individuals to remain anonymous, but providing contact information can help in the investigation process.
Q: Is there a deadline for submitting the Language Access Complaint Form?
A: The Language Access Complaint Form may have a specified deadline for submission, so it is important to submit the form as soon as possible after the incident occurs.
Q: What if I need assistance in filling out the Language Access Complaint Form?
A: If you need assistance in filling out the Language Access Complaint Form, you may seek help from a language access coordinator or an interpreter.
Q: Can I file a complaint in a language other than English?
A: Yes, the Language Access Complaint Form is available in multiple languages, including Arabic, to accommodate individuals who do not speak English fluently.
Form Details:
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