Deafblind Student Referral Information

  • We have a new Student Referral Form. Please discard and do not use versions distributed previous to August, 2017.

    1. Fill out the CRIS Student Referral Form and print. 

    2. Gather all required documents associated with the services being requested. For example, to request assistance with a evaluation to determine eligibility under deafblindness (DB), a copy of an audiogram and medical eye report is required. To initiate services for a student already eligible under DB, a copy of the current DB eligibility statement is required. 

    3. Obtain the signature of the special education director (or designee) in your district.

    4. Fax or mail the completed referral to CRP

    • Fax: 503-916-5576
    • Mail: Columbia Regional Program - 833 NE 74th. Ave - Portland, OR 97213

    If you have additional questions, contact Lea Cook at or call 503.916.5570 ext. 78235

    Return to the main Student Referral page.