Print form and mail to:

Project for New Mexico Children & Youth Who Are Deafblind
Center for Development and Disability
2300 Menaul NE
Albuquerque, NM 87107

OR fax to: (505) 272-5280

Call (877) 614-4051 for more information.

If you would like to receive free technical assistance for your child or a student who is deafblind (has both a vision and hearing loss), please complete and return this form to The Project for NM Children & Youth Who Are Deafblind. Once this information is received, you will be contacted to determine what the specific need is and the best time to schedule the visit.

WHAT KIND OF TECHNICAL ASSISTANCE ARE YOU INTERESTED IN?

WHAT TOPICS ARE YOU INTERESTED IN?

Auditory Training/Listening Skills
Assessment (vision, hearing, communication, development, transdisciplinary). Please Specify:
Behavior management (for preservative or disruptive behavior)
Communication System Development
Early Childhood Intervention
Daily Living Skills (personal care and self help skills such as toileting, dressing, etc.)
Inclusion into School Program (techniques that support the child's learning in the classroom)
Literacy Mode Determination (use of braille, large print, etc.)
Medical Issues (gaining more information about a child's diagnosed condition)
Orientation and Mobility Skills (travel independence)
Organizing a Daily Routine (sequence of activities, transition from one activity to another)
Personal Futures Planning (a system of looking ahead and planning for the future)
Sensory Skill Development (vision, hearing, tactile skill use)
Socio-Emotional Concerns (relationships with others)
Transition from Program to Program
Transition from School into Adult Services (college, rehabilitation, group home)
Vocation Training and Employment

Other areas of need: