IDB Submit a Referral
Please use this simple form to submit a referral to the Iowa Department for the Blind and we'll contact you to discuss the services you are interested in and answer any questions you may have.
Which county do you live in?
Black Hawk County
Buena Vista County
Cerro Gordo County
Des Moines County
Palo Alto County
Van Buren County
Please choose one
Adult Basic Education
Iowa Vocational Rehabilitation Services (IVRS)
Iowa Workforce Development (IWD)
Teacher or School Administrator
friend or family member
If other, please explain
What services are you interested in receiving? Please check all that apply.
Vocational Rehabilitation Services -- I'm interested in going to work.
Independent Living -- I'd like to learn how I can live independently and enjoy life.
Orientation Center -- I'd like to learn more about developing blindness skills and building confidence through center training.
Library Services -- I'd like to recieve talking books, braille books, or large print books.
I'm not sure yet, I'd like to learn more about these services.
Have you received any services from the Iowa Department for the Blind before or is this your first experience with us?
I have received services before.
I haven't received services from the department before.
I'm not sure
Please use this field to submit any other useful information.
How do you prefer to be contacted?
Do Not Fill This Out