CHIS Interpreter Forms
Download Community Health Interpreter Service (CHIS) Encounter Form
- Fill out the Encounter Form which includes patient information that has been provided, as well as the actual time that was spent at the appointment from start
- Obtain the signature of the person authorizing interpreting for the department.
- Return the completed Encounter Form to the Blue Ridge AHEC office, which will initiate an invoice to the specified person/department.
Download Community Health Interpreter Service (CHIS) Evaluation Form
- Provide an Evaluation Form to the provider to complete at the end of every appointment.
- Ask the provider to fax the completed Evaluation Form to Blue Ridge AHEC at (540) 568-3172. They may also return the form to you.
- If the provider returns the completed Evaluation Form to you, deliver the form to Blue Ridge AHEC with other documents on a payroll day.
Download Community Health Interpreter Service (CHIS) Time Sheet
Time sheets must be completed with name and turned into Blue Ridge AHEC. When you complete your time sheet
- Your handwriting must be as legible as possible to receive proper payment
- Be sure you have signed your time sheet
