Limited English Proficiency Interpreter Use Log

Log each interpreter use instance, including language, modality, and qualified-interpreter status, for monitoring language access delivery in direct-service programs.

Encounter and Submission Details

• Encounter Date
  Date the interpreter was used or requested.
• Program or Service Area
  Name of the direct-service program where language access was provided.
• Service Setting
  Where the encounter took place.
• Submitted By
  Name of the staff member completing this log entry.
• Submitter Role
  Staff role or title of the person completing the log.

Language Access Need

• Preferred Language
  Language requested by the client or identified by staff.
• How Was the Language Identified?
  How staff determined the language need.
• Was an Interpreter Requested?
  Indicate whether interpreter support was requested for the encounter.
• Who Requested the Interpreter?
  Shown when an interpreter was requested.
• Was There a Language Access Barrier?
  Indicate whether communication was delayed or limited due to language access.

Interpreter Modality and Qualification

• Was an Interpreter Used?
  Select yes if any interpreter support was used during the encounter.
• Interpreter Modality
  Shown when an interpreter was used.
• Interpreter Type
  Shown when an interpreter was used.
• Qualified Interpreter Used?
  Indicate whether the interpreter met your program's qualified-interpreter standard.
• Interpreter Name or ID
  Optional internal identifier for the interpreter. Avoid collecting unnecessary personal data.

Outcome and Follow-Up

• Was Communication Successfully Completed?
  Indicate whether the encounter could proceed with adequate understanding.
• Follow-Up Needed?
  Select yes if additional language access support is needed.
• Follow-Up Action
  Shown when follow-up is needed. Select all that apply.
• Notes
  Add brief, factual notes only. Do not include unnecessary PII or sensitive details.