iPad Application Form

Apply to get a no-cost iPad for video and audio interpreter services.

HPSM is making a limited supply of iPads available at no cost to providers who have patients with limited English language proficiency or sensory impairment. We are giving iPads out on a first-come, first-served basis to solo primary care providers, occupational/physical therapy providers and providers with patients who use American Sign Language.

We’ll provide you with an iPad that is configured to only access on-demand video and audio interpreter services, as well as HPSM’s Language Assistance Services (LAS) manual. Note that you must have Wi-Fi to use the iPad. For more details, visit www.hpsm.org/providers-ipad.

To apply for an iPad, complete and submit the form below.

iPad Program Participation Request Form

Clinic Name:

Name of Requestor

Clinic Address:

Phone Number:

Email:

Have you accessed interpreter services through HPSM in the last 12 months?

Yes

Don't know

How do you typically access HPSM interpreter services? Please choose all that apply

Phone/Telephonic

Video Remote

In-Person Interpreters for Spoken Language

In-Person Interpreter for American Sign Language and Deaf Interpretation

I have not used HPSM interpreter services

Approximately how many of your patients require interpreter services?

Why do you think having an iPad would improve access to HPSM interpreter services in your office? Please be as detailed as possible.

COVID-19 information

Monkeypox information

Power Outages

iPad Application Form

Apply to get a no-cost iPad for video and audio interpreter services.

iPad Program Participation Request Form