Medical Interpreter Waiver and Consent Forms

Getting a Medical Interpreter Waiver Form

  • Waiver form can be found on the Nebraska Medicine Interpretive Services intranet page
  • Provider will have to read the waiver form to the interpreter
  • The waiver form is only valid if read by the patient or by a professional medical interpreter
  • Staff must document interpreters identification number on waiver form and in One Chart

Monday – Friday

8 a.m. to 4:30 p.m.

  • Call 402.559.8697

Saturday and Sunday

  • 8 a.m. to 4:30 p.m.
  • Page 402.888.0646

After Hours and Holidays

  • Use the Certified Languages International number provided to all health care workers

Other Languages Waiver Form

Use direct dial instructions from Certified Languages International for other non English patients

Deaf / ASL Waiver Form

For questions request VRI

Consent Needed Form

Spanish

Monday – Friday

6 to 8 a.m.

  • Page 402.888.0646

8 a.m. to 4:30 p.m.

  • Call 402.559.8697

4:30 p.m. to 10 p.m.

  • Page 402.888.0646

10 p.m. to 6 a.m.

  • Use a standard phone with dial direct instructions

Saturday and Sunday

8 a.m. to 4:30 p.m.

  • Page 402.888.0646

4:30 p.m. to 8 a.m.

  • Use a standard phone with dial direct instructions

Holidays

  • Anytime
  • Use a standard phone with dial direct instructions
  • If a staff interpreter is needed, page 402.888.0646

Other Language

  • Obtain English Forms
  • Use a standard phone with dial direct instructions
  • Staff must document interpreters identification number on consent form and in One Chart

Deaf

  • Obtain English Forms
  • Use the Video Remote Interpreter (VRI)

Monday – Friday

8 a.m. to 4:30 p.m.

  • Call 402.559.8697

4:30 p.m. to 10 p.m.

  • Page 402.888.0646

10 p.m. to 8 a.m.

  • Call 402.559.2337

Saturday and Sunday

8 a.m. to 6 p.m.

  • Page 402.888.2525

6 p.m. to 8 a.m.

  • Call 402.559.2337

Holidays

  • Anytime
  • Call 402.559.2337