Schedule a New Interpreter Request

This form is for booking an interpreter for new appointments.

If you need to cancel/change a previous interpreter request,
please use our Cancel/Reschedule form or call us at 859-312-8559.

Do you need an interpreter for an appointment WITHIN THE NEXT 3 BUSINESS DAYS? *

YES

NO

For appointments that will occur within the next 3 business days:

Please call our direct line at 859.312.8559 and speak directly to our dispatcher on-call who will assist you with scheduling. Thank you!

Please select the Center, then select your Clinic. *

BAPTIST HEALTH — 1760 Nicholasville Rd. *

Pediatric Community Cardiology — Suite 602 (SI = 101)

BEAUMONT — 3101 Beaumont Centre Cir. *

Bluegrass Care Clinic (SI = 85)

CARDINAL HILL — 2050 Versailles Rd. *

Outpatient Therapy (SI = 334)

Physical Medicine & Rehab (SI = 119)

CHANDLER PAV A — 800 Rose St. *

Radiology — Ground Floor (SI = 262)

CHANDLER PAV H — 800 Rose St. *

Endoscopy — 3rd Floor (SI = 134)

Nuclear Medicine — Ground Floor (SI = 145)

Precision Medicine — 2nd Floor (SI = 320)

Pulmonary Function Lab — 5th Floor (SI = 148)

Radiology *PLEASE SPECIFY WHICH FLOOR IN NOTES SECTION* — Ground Floor and 2nd Floor (SI = 142)

Vascular Lab — 5th Floor (SI = 153)

CHILD DEVELOPMENT CENTER — 290 Alumni Dr. *

Pediatric Therapies (SI = 269)

CT WETHINGTON BUILDING — 900 S. Limestone *

Peds Developmental & Behavioral Health — Suite 110 (SI = 305)

DR. JAMES AKIN *

Bluegrass Fertility Center — 1760 Nicholasville Rd Suite 501 (SI = 220)

IVF Lab — 2716 Old Rosebud Road Suite 210 (SI = 220)

FOUNTAIN COURT — 245 Fountain Ct. *

Primary Care — 1st Floor (SI = 330)

Psychiatric & Behavioral Health — 3rd Floor (SI = 89)

GILL HEART INSTITUTE — 800 Rose St. *

Cardiology — 1st Floor (SI = 90)

Cath Lab — 2nd Floor (SI = 126)

Center for Advanced Surgery — 3rd Floor (SI = 127)

Coumadin Clinic — Ground Floor (SI = 91)

ECHO Lab — Ground Floor (SI = 132)

Infusion — Ground Floor (SI = 137)

Radiology — Ground Floor (SI = 136)

GOOD SAM MOB/MAXWELL — 125 E. Maxwell St. *

Cardiology — Suite 200 (SI = 93)

OB/GYN *PLEASE SPECIFY SUITE NUMBER IN NOTES SECTION* — Suite 140 & 300 (SI = 95)

OB/GYN Spanish Shift — Suite 140 & 300 (SI = 273)

Orthopedics — Suite 201 (SI = 96)

Physical Therapy — Suite 101 (SI = 255)

Surgical Specialties — Suite 302 (SI = 97)

Urology — Suite 303 (SI = 332)

GOOD SAM PAC/MAXWELL — 135 E. Maxwell St. *

Asthma, Allergy & Sinus — Suite 250 (SI = 92)

Cardiopulmonary Rehab — Suite 103 (SI = 299)

Nephrology Bone & Mineral Metabolism — Suite 401 (SI = 98)

Pediatrics — Suite 200 (SI = 113)

Pre-Admission/Pre-Op — Suite 101 (SI = 263)

Specialty Care *PLEASE SPECIFY WHICH SPECIALTY IN NOTES SECTION* — Suite 301 (SI = 283)

Speech Therapy — Suite 402 (SI = 149)

Wound Care — Suite 318 (SI = 213)

GOOD SAM HOSPITAL — 310 S. Limestone *

Radiology — 2nd Floor (SI = 239)

Sleep Disorders Center — 4th Floor (SI = 155)

KY CHILDREN'S HOSPITAL — 800 Rose St. *

Dance Blue Pediatric Hematology and Oncology — 4th Floor (SI = 116)

KY CLINIC 1ST FLOOR — 740 S. Limestone *

General Surgery — Wing D (SI = 18)

KNI: Neurology — Wing C (SI = 19)

Orthopedics — Wing C (SI = 20)

Physical Therapy — Wing D (SI = 147)

Pre-Op Anesthesia — Wing C (SI = 151)

Radiology — Wing C (SI = 281)

Vascular Interventional Radiology — Wing C (SI = 327)

KY CLINIC 3RD FLOOR — 740 S. Limestone *

Cardiothoracic Surgery — Wing D (SI = 79)

ENT — Wing C (SI = 82)

Nutrition Clinic — Wing D (SI = 76)

Transplant — Wing D (SI = 150)

Voice and Swallow — Wing C (SI = 124)

Women's Health — Wing D (SI = 80)

KY CLINIC 4TH FLOOR — 740 S. Limestone *

Adolescent Medicine — Wing D (SI = 84)

Pediatric Behavioral & Developmental Health — Wing D (SI = 203)

KY CLINIC SOUTH — 2400 Greatstone Point *

General Pediatrics — 2nd Floor (SI = 87)

General Pediatrics Spanish Shift *PLEASE SPECIFY TYPE OF COVERAGE IN NOTES SECTION* — 2nd Floor (SI = 270)

Interventional Pain — 1st Floor (SI = 88)

Radiology — 1st Floor (SI = 296)

Team Blue Primary Care — 1st Floor (SI = 287)

MARKEY ROACH BUILDING — 800 Rose St. *

Head, Neck & Respiratory — 2nd Floor (SI = 294)

Hematology — 1st Floor (SI = 138)

Outpatient Palliative Medicine — 1st Floor (SI = 335)

Radiation Oncology — 1st Floor (SI = 152)

POLK-DALTON — 217 Elm Tree Lane *

Internal Medicine & OB/GYN *PLEASE SPECIFY TYPE OF APPT IN NOTES SECTION* (SI = 121)

SANDERS BROWN — 2199 Harrodsburg Rd. *

Memory Clinic (SI = 329)

SHRINERS — 110 Conn Terrace *

Eye Clinic *PLEASE SPECIFY WHICH FLOOR IN NOTES SECTION* — 4th & 5th Floor (SI = 256)

UNIVERSITY HEALTH — 830 S. Limestone *

Behavioral Health — 4th Floor (SI = 110)

Internal Medicine — 3rd Floor (SI = 83)

WHITNEY-HENDRICKSON — 800 Rose St. *

Comprehensive Breast Care — 2nd Floor (SI = 129)

Gynecology Oncology — 3rd Floor (SI = 109)

Infusion *PLEASE SPECIFY WHICH FLOOR IN NOTES SECTION* — 1st & 2nd Floor (SI = 324)

Integrative Medicine & Health — 3rd Floor (SI = 300)

Multidisciplinary — 1st Floor (SI = 143)

OTHER

Please provide the name and location of your clinic.

Clinic Contact Name

Clinic Phone Number

Appointment Date: *

Please use the calendar pop-up for date entry. If typing the date directly, format as DD/MM/YY; other formats will cause errors.

Appointment Time *

Please do NOT list the patient’s arrival time. The interpreter will arrive 15 minutes before the appointment time.

Is this a NEW patient? *

Yes

No

Patient Name *

Medical Record Number *

Provider Name *

Notes: estimated length of visit/reason for visit/special requests *

Your Name *

Your DIRECT Phone Number *

Your Email Address *

Please click the submit button only once, and then wait for the confirmation screen.

CONFIDENTIALITY STATEMENT

THIS IS A SECURE MESSAGE WHICH WILL BE DELIVERED SOLELY TO PURE LANGUAGE SERVICES, INC. ANY DISCLOSURE, COPYING, DISTRIBUTION, OR TAKING OF ANY ACTION IN RELIANCE ON THE CONTENT OF THIS INFORMATION OUTSIDE OF THE TREATING TEAM FOR THIS PATIENT IS STRICTLY PROHIBITED.

859-312-8559

apply@purelang.com

859-312-8559

apply@purelang.com

Schedule a New Interpreter Request