Dolmetscheranforderung

Landratsamt

Landratsamt Sächsische Schweiz-Osterzgebirge

Sozial- und Ausländeramt

Referat Asylleistung und Unterbringung

Schloßhof 2/4

01796 Pirna

application for interpreter

DE | EN

Important note if you select English:

Your answers and entries in the form must be in German! Otherwise we cannot process your application.

1. personal details of the patient/client

name*

first name*

street*

street number*

post code*

city*

birth date*

nationality*

phone

email*

Please note: The application will be sent to this email address at the end for printing. Please check that the spelling is correct!

current certificate (like a voucher) for medical treatment is requested or already received*

yes

no

2. appointment details/ details for the interpretation

date*

time*

estimated duration

adress of the place of use:

Name des Arztes/ der Klink/ der Praxis*

street*

street number*

post code*

city*

language*

eventually the name of the previous interpreter

content of the appointment*

reason*

I understand that I have to pay for the interpreter myself if I do not come to the appointment and have not cancelled beforehand. The appointment must be cancelled in writing in advance and in good time at the Asylum Benefits and Accommodation Department (Referat Asylleistung und Unterbringung). The interpreter can then be informed and cancelled and no costs will be incurred.*

date

signature (after printing)

Please note:

As soon as you click on ‘Send’, no more changes can be made to the form.

Your application will be sent to the e-mail address given above. Please pay attention to the correct spelling!

Please print out your application and submit it with your original signature to the Asylum Benefits and Accommodation Department.