BVI Student Referral Information

  • We have a new Student Referral Form. Please discard and do not use versions distributed previous to October 2021.

    If you suspect that a student will be eligible for special education under the category of Visual Impairment (VI):

    1. Obtain a medical eye report completed by an optometrist or ophthalmologist. This report should inlude diagnosis and acuities, and should be included with the referral. CRIS's eye report form is recommended. 
    2. Complete a CRIS Student Referral Form.  
    3. For a student moving in with an existing VI eligibility, please include the move-in eligibility form and IEP.
    4. Fax or mail the completed referral and eye report to CRIS.
      • Fax: 503-916-5576
      • Mail: Columbia Regional Inclusive Services - 833 NE 74th Ave. - Portland, OR 97213

    When CRIS receives the referral:

    1. CRIS contacts the person who submitted the referral.
    2. The referring district or agency convenes the evaluation planning meeting to obtain parent consent to evaluate. A teacher of the visually impaired (TVI) is available upon request to assist with evaluation planning. 
    3. Under procedures/tests, the consent to evaluate should list:
      • Functional Vision Assessment: To determine how a child uses vision in functional, everyday tasks. Used to determine educational impact and guide IEP planning.
      • Learning Media Assessment (for children age 3 and up)To determine the student's primary learning/literacy medium.
    4. The TVI conducts the assessment(s).
    5. The referring district convenes a meeting to review evaluation results, determine eligibility, and write/amend the eligible student’s IEP.



    Q. What are the requirements to establish eligibility under Visual Impairment and receive regional BVI services?

    A. At least two assessments are required for VI eligibility:

    • an examination by an ophthalmologist or optometrist which indicates
      • The child has a visual impairment that is uncorrectable by medical treatment, therapy or lenses, OR
      • The vision examination results are inconclusive and the child demonstrates inadequate use of residual vision
    • a functional vision assessment by a teacher of the visually impaired

    A child is eligible when the educational team determines that:

    1. The child’s visual impairment, even with correction, has an adverse impact* on the student’s educational performance or developmental progress; and
    2. The child needs special education services.


    *"Adverse impact" is determined differently depending upon the age of the student. For students in kindergarten through age 21, the student’s disability has an adverse impact on the student’s educational performance. For children age three up to kindergarten, the student's disability has an adverse impact on the child’s developmental progress.

    Q. Who is responsible for obtaining the medical eye report?

    A. The referring district, program or ESD is responsible for obtaining and submitting the medical eye report along with the CRIS referral. The eye report is necessary to complete the VI eligibility determination.

     Q. Can the standard Medical or Health Assessment Statement or Medical Condition Statement be used for VI evaluations and to establish eligibility?

    A. Not by itself. The Medical or Health Assessment Statement or Medical Condition Statement provides very limited information and lacks the details necessary (e.g.: diagnosis, acuity) for determining eligibility.

    Q. What can I do to ensure that we obtain the eye report in a timely manner?

    A. Here are some tips:

    • Obtain a signed release of information from the parents as soon as possible between the medical eye care provider and the school.   Some providers (like Casey Eye/OHSU and Kaiser Permanente) require that you use their own release of information form.
    • Call first and ask if clinic has specific process for requesting reports.
    • Consent form should include the name of the clinic and/or specific doctor who is releasing this information.
    • Fill out the form carefully.
    • Consent form should include releasing information to the district and to Columbia Regional Inclusive Services.
    • Include the child’s date of birth.
    • Submit the request for the medical eye report right away. Turn-around times vary by clinic.

    Q. Do you have a list of contacts for eye health care professionals in the community?

    A. We don’t maintain a provider list. EI/ECSE agencies have lists of providers, and families can check with the primary care provider, insurance provider, or do an online search.

    Q. What kind of evaluations do we need to do an eligibility for a vision impairment?

    A. The Teacher of the Visually Impaired (TVI) will conduct a Functional Vision Assessment for children of all ages. The Teacher of the Visually Impaired (TVI) will additionally conduct a Learning Media Assessment for children age three and older.

    If you have additional questions, contact Kate Dilworth or call 503.916.5570 ext. 78243

    Return to the main Student Referral page.