LSUHSC School of Allied Health Professions Human Development Center

Louisiana Deafblind Project
Referral Packet

LADBP Enrollment Welcome Letter

Dear Parents/Guardian:

Thank you for enrolling your child with the Louisiana Deafblind Project for Children and Youth. Students qualify for inclusion in the Project’s work when they present with concomitant, permanent hearing and vision impairment resulting in communication, developmental and/or educational needs that cannot be accommodated in special education programs solely for children with deafness or children with blindness.

Verification regarding your child’s hearing and vision impairment is required. Also, verification of your child’s need for special education services is required. These verifications can be accomplished by providing the Project copies of hearing evaluations, vision evaluations, educational evaluations, Individual Education Plan (IEP) or Individual Family Service Plan (IFSP). All information regarding your child is held in confidence.

Personal education and healthcare information is protected by Federal laws including the Family Educational Rights & Privacy Act (FERPA) & Health Insurance Privacy & Accountability Act (HIPAA). These laws make sure your child’s educational & health information is kept private and requires that we give you notice of our legal duties and privacy practices. Included in this packet of information is a Notice of Privacy Practices Protected Health Information which details our obligations under HIPPA. Please review this document. Once reviewed, please complete the Acknowledgement of Receipt of Notice of Privacy Practices form and return it to the Louisiana Deafblind Project along with the other application materials. The following check-list may assist you in organizing the needed information for your child.

Documents in This Packet

Documents Available via the LADBP Technical Assistance PageTechnical Assistance Page, http://www.hdc.lsuhsc.edu/ladbp/ladbptechassisstance.aspx

Additional Required Official Documentation

Thank you again for enrolling your child with the Louisiana Deafblind Project for Children and Youth. We look forward to working with your child and your family.

Sincerely,

Michael C. Norman, Coordinator

LADBP Registry Referral Application

Information about Child/Youth with Deafblindness

*Phone Type (check one):
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Information about the Person Completing This Form

*Phone Type (check one):