Memorandum

To:___________________________________

From:________________________________

Date:_________________________________

Subject: Communication Accessibility

I CANNOT GIVE “INFORMED CONSENT” UNLESS

I HAVE A QUALIFIED INTERPRETER AS IS

REQUIRED BY FEDERAL LAW.

PLEASE PUT A COPY OF THIS IN MY FILE.

_____________________________________________

If you have any questions, please call toll free:

Department of Justice -- 1-800-514-0301 (voice) or 1-800-514-0383 (tty)

Michigan’s Division on Deaf and Hard of Hearing--1-877-499-6232 (voice/tty). _____________________________________________

Copyright 1997
By: Brinks & Associates, Attorneys (Grand Rapids, Michigan)
Permission is hereby granted to reproduce this document without charge as long as this notice is reproduced on all copies.