Deaf-Blind Program - How to Make a Referral
Who should contact the Deaf-Blind Program?
- Parents or professionals with questions about a child who they suspect meets the criteria for deaf-blind services.
- Parents or professionals interested in a consultation for a deaf-blind child. Consultations are provided free of charge.
- Parents or professionals who have the need for training regarding interventions for children or youth who are deaf-blind.
- Families who are seeking support from other families who have a family member who is deaf-blind.
The following forms are required for a request of services from the Deaf-Blind Program. Download the forms, complete them by typing in the boxes, print the forms, sign the forms, and return the completed forms to the Center for Disabilities.
- Deaf-Blind Program Referral Form
- Informed Consent Form
- Release of Information Form
- Agency Consent for Consultation Form
To make a referral to the Deaf-Blind Program, contact:
Center for Disabilities
1400 West 22nd Street
Sioux Falls, South Dakota 57105
Phone - 800-658-3080 (Voice/TTY) or 605-357-1439
E-mail - firstname.lastname@example.org