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  • LLAC Hotline Intake Form

    LLAC Hotline Intake Form

    Thank you for taking the time to contribute to community data, make a complaint and request resources! This is not an official report. ALL INFORMATION IS CONFIDENTIAL. Please include as much detail as possible. You may leave out your name if you would like to remain anonymous.
  • Format: (000) 000-0000.
  • Preferred Mode of Communication
  • This complaint is for*
  • Preferred spoken language*
  • Preferred written language*
  • Parish (where you live)*
  • Why are you contacting LLAC today?*
  • If you are filling out this form online, would you like a LLAC volunteer to contact you?*

  • Language Access Complaint

  • Where were you when you were denied or could not access language services?
  •  - -
  • Were you told you had to bring your own interpreter?
  • If you brought an interpreter, did they charge you a fee?
  • Would you like a representative from LLAC to contact you to support you in making a report or other advocacy?

  • More Information and Resources

  • Do you know what your Title 6 language access rights are?*
  • Is there a specific area of language access rights that you are interested in learning more about?
  • What kind of resources are you looking for in your community?
  • How would you prefer to receive these resources from LLAC?

  • Follow up & Feedback

  • How did you hear about the Louisiana Language Access Hotline?*
  • Is it ok if a volunteer contacts you in a couple of weeks to follow up on the resources we have provided?*
  • We are hoping to include community members in our data collection and advocacy efforts. Would you be interested in learning about ways you could be involved in the LLAC hotline or other initiatives and campaigns?*
  • Would you like to receive a copy of your responses by email?*
  • Should be Empty: