PLEASE SUBMIT ALL FORMS WITH ANY IDENTIFYING INFORMATION (names, addresses, birth dates, etc.)
- By Fax: 352-273-8539
- OR POSTAL MAIL:
Florida & Virgin Islands Deaf-Blind Collaborative
PO Box 100234
1600 SW Archer Road
Gainesville, FL 32610
- EMAIL IS NOT A HIPAA-COMPLIANT MEANS OF EXCHANGING PROTECTED INFORMATION
About the Census
The Florida deaf-blind project is responsible for recording data on the children and young adults with deaf-blindness in our state. School districts are required to report students with both vision and hearing losses to the project. Children and young adults with deaf-blindness are entered in the Florida registry as they are identified and reported to us. The “census” is updated annually, based on the December 1st statistics. Ages, etiologies, sensory loss levels, other disabilities, and de-identified demographic information are reported annually to the federal government via the National Child Count report.
“Census” forms are used to report children and young adults (ages birth – 22 years) to the Florida deaf-blind project. Individuals with both vision and hearing loss (diagnosed or suspected) will be added to the Florida Deaf-Blind Registry (see more info on the National Child Count of Children and Youth who are Deaf-Blind here).
Children and young adults who have been reported to the Florida Deaf-Blind Registry are eligible for Florida deaf-blind project services.
Any professional or family member may report an individual with combined vision and hearing losses to the Florida deaf-blind project (please see Blank Census Record and Census Instructions below).
Forms must be PRINTED AND FAXED to 352-273-8539!
- For Families reporting their child with deaf-blindness
- Blank census record
- If a Part C student has transitioned to Part B or left your region . . .
- If a Part B student has graduated or left your district . . .
Part C Early Intervention and healthcare providers should obtain Consent For Exchange of Information or report de-identified profiles of children and youth with deaf-blindness to the Florida deaf-blind project.
When collecting data for the National Child Count of Children and Youth Who Are Deaf-Blind (aka “census”), the Florida deaf-blind project functions as a HIPAA-covered entity that transforms nonstandard information on children and youth with deaf-blindness into standard format for the annual census Under HIPAA, healthcare providers may disclose de-identified information to the Florida registry of children and youth who are deaf-blind without authorization. In compliance with HIPAA, FAVI transmits only de-identified information about the health and disability profiles of children and youth with deaf-blindness to the National Consortium on Deaf-Blindness for the annual census.
Help the Florida deaf-blind project to help children and youth with deaf-blindness and their families!
Encourage families to complete a Consent for the Exchange of Information & Records, so that we can provide information and offer services to children with deaf-blindness, their families, and their educational teams.
Once a family has provided consent, any family member or team member may make a request for Technical Assistance from the Florida deaf-blind project.