It is to help us identify the needs of Deaf-Blind individuals, and it will be used as a census. The government loves numbers; the more DB individuals are identified, the more financial support we receive for much needed programs, such as SSP programs, transportation, and DB interpreting.

This new form has the following information that the old one did not have:

  • County
  • Phone number
  • Type of Phone
  • Birthdate
  • Gender

    The phone number is part of the confidential information that we will not distribute along with address and cause of vision and hearing loss. The statistical information that we will use are:

  • County -- to determine location of need
  • Type of phone to ensure that these devices are noted as most used
  • Age and gender are common demographic information
  • Communication needs will also help toward determining specific needs

    To assure those who have not completed the new registry form, no one's personal information (name, address, phone number or email address) will be distributed. Any information that is used will be strictly used for statistical purpose to present data information for future funding and approaching legislators for more effective laws and resources.

    Confidentiality is one of FDBA's top priorities.

    YOU who are Deaf-Blind do make a difference! By participating in this registry you will empower FDBA to continue in their mission to serve YOU!

    So...PLEASE complete the new registry form and SPREAD THE WORD with everyone you know that has combined vision and hearing loss and with organizations (businesses) that work with Deaf-Blind individuals.

    Do you need a step-by-step instruction on how to fill out online registry, please click the 'Step-By-Step' button below.


    Choose PDF format to print and complete by hand and mail to:
    Please note the PDF file has a window that pops up, it is okay to select 'open' to open up the document.

    Darlene Laibl-Crowe
    114 Tanner Terrace
    Palatka, FL 32177

    To fill in document and save as a file to attach to email; choose the Word format.

  • To save this document, click on the upper left corner where a Circle (ribbon) is and type A or choose 'Save As' and type your name in the Document name and click 'Save'
  • Next, open new email, select Attachment or a paper clip symbol and a window will open.
  • Scroll down and find the file you saved the document in and double click it and it will save to your email.
  • Send the email to Darlene Laibl-Crowe

    For more assistance, please contact Darlene Laibl-Crowe

    Thank you so much for participating in our No Deaf Blind Floridians Left Behind campaign!!


    The Brochure is to inform the public what FDBA is all about and what it has to offer.

    PDF Format
    MS Word
    Online Registry

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