Please complete the form below to submit a referral to the Kentucky Deaf-Blind Project. We will be in touch soon to assist with the referral.

The first seven questions are required, but we encourage you to provide as much additional information as possible. The more we know, the better we can help the child.

You may also download a printable version of the referral form and return to:

Kentucky Deaf-Blind Project
229 Taylor Education Building
597 South Upper Street
Lexington, KY 40506-0001

Referrals can be emailed to or faxed to (859) 257-1325.

Referral Form