Help the Florida & Virgin Islands (FAVI) Deaf-Blind Collaborative to help children and youth with deaf-blindness and their families!
Any family member or professional may report a child or young adult ( ages birth through 21) to the Florida deaf-blind registry by contacting FAVI at 1-352-273-7529.
PLEASE SUBMIT ALL FORMS WITH ANY IDENTIFYING INFORMATION (names, addresses, birth dates, etc.)
- BY FAX 352-273-8539
- OR Contact Shelly Voelker (firstname.lastname@example.org) for mailing instructions.
- Email is not a HIPAA-compliant means of exchanging protected information.
Referral Forms and Information
- For Families reporting their child with deaf-blindness
For others making a referral:
- Report a child or young adult to the deaf-blind registry
Once an individual has been reported to the Florida deaf-blind registry, a family, teacher, or educational team may request individualized assistance from the FAVI D-B Collaborative.
To request individualized assistance:
- Consent for the Exchange of Information & Records,
A parent/guardian needs to complete a Consent form, so that we can provide individualized information and services to a child or young adult with deaf-blindness, his/her family, and other educational team members.
Once a family has provided consent, any family member or team member may make a request for Technical Assistance (training, consultation, individualized support) from the FAVI D-B Collaborative.
- Request for Technical Assistance