Make a Referral or Request Assistance

Help  the Florida & Virgin Islands (FAVI) Deaf-Blind Collaborative to help children and youth with deaf-blindness and their families!

Family Intake Survey

The FAVI Deaf-Blind Collaborative encourages families to report their child / young adult
(birth through age 21) with multiple disabilities that include
diagnosed or suspected hearing and vision loss using the online Family Intake survey
(available in English and Spanish).

Request individualized assistance for your family and / or your child’s educational team
using the online Family Intake survey

Educators and professionals should also make referrals using the Family Intake survey,
but consent must be provided by a parent/guardian for exchange of information and records.

Educators who are simply reporting a student to the Florida Deaf-Blind Registry, as required by Florida statute, should use the online Educator survey
(available in English and Spanish)

Consent for Exchange of Information & Records

Parent(s) / Guardian(s) must provide consent for the exchange of information and records before child-centered consultation with educators and professionals may occur.  The family will indicate which individuals and organizations may exchange information and what types / formats of information may be shared.

Once a family has provided consent, any authorized family member or team member may make a request for Technical Assistance (training, consultation, individualized support) from
or participate in child-centered consultation with the FAVI Deaf-Blind Collaborative.

Reporting by mail or fax:

(names, addresses, birth dates, etc.)

  • BY FAX 352-273-8539 OR Contact Shelly Voelker (
    for mailing instructions. 
    Email is not a HIPAA-compliant means
    of exchanging protected information.