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Communication Card As DeafBlind

Use the form below to create a DeafBlind accommodation card. It will allow you to create a personalized communication accommodation message. You may select the most appropriate options that are fitting for you and your communication needs. When completed, click on the “Create Card” button below to create your communication card. Print the card and keep it with your other identification cards.

When clicking on the “Create Card”, the outcome of the card will only show
what you chose as your preferred option(s).

To create a Communication Card, I am:

DeafBlind

I am DeafBlind.

*My full name is

*To communicate effectively, I need: (Please select more than one item if needed)

Licensed Sign Language Interpreter
Braille
Dark/bold, enlarged written words
Face to face lip reading
Gestures
*Other (please specify):

*Who to contact and their phone number for what I need:
(Example: an Interpreter agency and its phone number)

*In case of emergency, contact:
(Example: your relatives and their phone number)

OFFICE

Illinois Deaf and Hard of Hearing Commission
528 South Fifth Street, Suite 209
Springfield, Illinois 62701
Office Hours M-F: 8:30am - 4:30pm
Contact Us

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