If this is the entirety of the document you received, it would appear it is looking for a date. The highlighted portion of your response is what I am basing this information on. Perhaps this is something similar to a 'representative' form, asking you for how long you wish to be this persons interpreter?
Or, perhaps they are wondering what language it will be spoken in and which language you will be translating it to?
Example: From: Yittish To: English
Is there a location for someone to sign at the bottom or is that the full extent of it? If no signature required or it doesn't need to be sent back prior to her appointment, you can likely take it with you and ask for clarification.
There really isn't a lot of information on it to make more of an educated guess.
Best of luck to you !
