Additional Referral Information
The following sets of fields are optional and chosen by selecting yes to each of the following questions:
- Family Doctor Information
- Legal Representation
- Employer Information
- Interpreter Required
- Transportation Required
Contents
Family Doctor Fields
The following fields are specific to the associated family doctor:
Legal Representation Fields
The following fields are specific to the associated legal representation of the claimant:
Employee Information Fields
The following fields are specific to the employment of the claimant:
Claimant Special Needs
The following fields describe any special needs that the claimant may have for interpreter or transportation:
Languages
The following languages are displayed in the language list:
- English
- Afrikaans
- Akan
- Albanian
- ASL
- Amharic
- Arabic
- Armenian
- Assyrian
- Ashanti
- Azerbaijani
- Bengali
- Bosnian
- Bulgarian
- Burmese
- Cambodian
- Cantonese
- Catalan
- Chinese
- Creole
- Croatian
- Czech
- Danish
- Dari
- Dinka
- Dutch
- Estonian
- Ewe
- Fanti
- Farsi
- Finnish
- Flemish
- Frafra
- French
- Fuchow
- Fukienese
- Ga
- German
- Greek
- Gujarati
- Hakka
- Hausa
- Hebrew
- Hindi
- Hungarian
- Ibo
- Ilocano
- Indonesian
- Italian
- Japanese
- Katchi
- Kermanji
- Korean
- Kurdish
- Kwa
- Lao
- Latin
- Latvian
- Lithuanian
- Macedonian
- Malay
- Malayalam
- Maltese
- Mandarin
- Marathi
- Norwegian
- Pilipino
- Persian
- Polish
- Portuguese
- Punjabi
- Pushtu
- Romanian
- Russian
- Serbian
- Shanghai
- Singhalese
- Slovak
- Slovenian
- Somali
- Spanish
- Swahili
- Swedish
- Tagalog
- Taiwanese
- Tamil
- Telugu
- Thai
- Tigrinya
- Toisan
- Turkish
- Twi
- Ukrainian
- Urdu
- Vietnamese
- Yiddish
- Yoruba
- Zulu
