Please complete the Child Count Form for any student in Nebraska who has a combined hearing and vision loss; this refers to any degree of hearing loss in conjunction with any degree of vision loss (students do not need to be totally deaf and/or totally blind). Students do not need to be verified Hearing Impaired, Visually Impaired, or Deaf-Blind on their MDT. The child count is a separate record-keeping system compiled by each state's deaf-blind project; only numerical data is reported to the National Center on Deaf-Blindness; names are kept strictly confidential.

Completed PDF forms should be returned to Mackenzie Savaiano, Project Coordinator, via email or by U.S. mail:

Nebraska Deaf-Blind Project
Attn: Mackenzie Savaiano
202 Barkley Memorial Center
PO Box 830738
Lincoln NE 68583-0738