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NJ DCF Logo with reverse copy

 

New Jersey Department of Children and Families Policy Manual

 

Manual:

CP&P

Child Protection and Permanency

Effective Date:

Volume:

X

Forms

Chapter:

A

Forms

5-14-2012

Subchapter:

1

Forms

Issuance:

9.11

CP&P Form 9-11, Interpreter Services for the Deaf and Hard of Hearing

 

 

Click here to view or print the CP&P Form 9-11.

 

WHEN TO USE IT

 

The Interpreter Services for the Deaf and Hard of Hearing Form, CP&P Form 9-11, is used to advise a Deaf or hard of hearing client that, under the Americans with Disabilities Act, he or she, is entitled to a certified interpreter when speaking with a CP&P representative, and that CP&P will pay for the service.

 

HOW TO USE IT

 

The Case Worker gives CP&P Form 9-11 to the Deaf or hard of hearing client at the time of initial contact, and helps him or her to complete it, if necessary. If the client indicates he or she would like to have an interpreter, the Case Worker contacts the Division of the Deaf and Hard of Hearing, Interpreter Referral Services - (609) 588-2648 or (800) 792-8339 - to request a certified interpreter.

 

The client enters a check mark, to indicate the type of interpreter requested, if any, then signs and dates the form, to document receipt of it. The Case Worker signs and dates the form as well.

 

TIPS FOR COMPLETING THE FORM

 

After providing CP&P Form 9-11 to the client who is deaf or hard of hearing, request that the client completes the form (to document receipt of it/the Division's compliance with the Americans with Disabilities Act) as follows:

 

·        Enter a check mark to indicate the type of interpreter requested (American sign language, English, oral or Deaf/Blind interpreter, or "none");

 

·        Print their name;

 

·        Sign their name; and

 

·        Enter today's date.

 

The Case Worker then:

 

·        Prints their name;

 

·        Signs their name;

 

·        Enters the date;

 

·        Enters the name of the CP&P Office;

 

·        Enters the office address;

 

·        Enters the office telephone number; and

 

·        Enters the New Jersey Spirit identification number.

 

DISTRIBUTION

 

Original

-

CP&P case record

 

Copy

-

Client (upon request)