Get Physician And Staff Language Capabilities Form - Kern Family ...

This guide provides clear instructions on how to effectively complete the Physician And Staff Language Capabilities Form - Kern Family online. By following these steps, you can ensure that all necessary information is accurately recorded to reflect the language capabilities of your staff.

Follow the steps to fill out the form accurately.

1. Press the ‘Get Form’ button to access the form and open it in an editable format.
2. Fill in the provider or clinic name at the top of the form. This identifies the healthcare entity for which the language capabilities are being reported.
3. Enter the site address directly below the provider/clinic name. This should include the full street address, including city, state, and zip code.
4. If English is the only language spoken by you and your staff, check the corresponding box.
5. List the names of your physicians, registered nurses, nurse practitioners, and staff members in the designated fields. For each individual, specify their professional role.
6. For each person listed, indicate the languages spoken by entering them in the language sections provided. You can fill in up to three languages per person.
7. Rate the speaking, reading, and writing capabilities in each language using the scale from 1 (poor) to 5 (excellent). Ensure that each rating accurately reflects the individual's proficiency.
8. If more than the allotted number of individuals need to be reported, photocopy the relevant sections of the form for additional entries.
9. Once all sections are completed, review the entire form for accuracy and completeness before final submission.
10. Finally, save your changes, and choose to download, print, or share the filled-out form as necessary.

Complete the Physician And Staff Language Capabilities Form online to ensure your clinic meets communication needs effectively.