How To Make A Referral to the
BC Provincial Outreach Program for Students with Deafblindness

Step 1:  
If you suspect a student in your District may be functioning as a student with deafblindness. Gather all medical documentation regarding vision and hearing.

Step 2:
Contact the Coordinator of the Deafblind Outreach team at 604-668-7810, or email at <deafblind@sd38.bc.ca>. The Coordinator will be able to answer any questions about the Outreach program and get you started on making the referral for services. If there are any questions about the program, the Coordinator will be able to answer them. The coordinator may arrange for a pre-visit to meet the student and the school team, and help in filling out the forms if required.

If a pre-visit has been arranged, it is not necessary to include a video of the student with the referral as indicated in the referral forms.

Step 3:
Fill out the referral forms. These forms can be downloaded from the bottom of this page, or they can be mailed or faxed to you upon request.

Step 4:
If medical documentation is to be released directly from a doctor, a hospital, or other medical facility please send the original signed release forms directly to the office or organization holding the original forms. Signatures from the parents or guardians for release of information will be required.

Step 5:
Make sure all the necessary signatures have been added to the first page of the referral form: Parent / Guardian, Principal, Teacher, and District Administrator.

Step 6:
Mail the completed package to the
BC Provincial Outreach Program for Students with Deafblindness
10300 Seacote Road
Richmond, BC  V7A 4B2

OR Fax to:  604-668-7812

Follow-up:
Once all of the necessary documentation has been received, the Outreach Team will review the referral and let you know if your student has been accepted for service.

In some cases, if the team needs more information about the student's functioning level and/or visual and auditory abilities, your student may be put "on watch" for a period of time. A student "On watch" will receive some level of consultation, depending on need, but should not be claimed as deafblind at this point. This is intended to be a period of ongoing assessment for our team to determine if our services are appropriate for your student's needs.

The following Referral Form is in a downloadable PDF file:
REFERRAL FORM 2008 New.pdf