Get Help

We appreciate your interest in the Hands & Voices ASTra Educational Advocacy Program. While it can be difficult to put into words the many concerns you may have about your child, please fill out this form completely. It will help us understand your situation and will give us the necessary information to support you in your child’s education planning

If you have letters and/or supporting documentation, please attach them to your submission. PLEASE NOTE: file uploads may not work on some mobile devices. Any documents you are unable to upload, may be submitted separately. Instructions will be contained in your confirmation email for email/fax/mail submission options.

We know this is a long form, but it will be helpful to your child’s IEP!

We cannot schedule a time with you to talk or plan to attend any meetings with you until this form is completed.

NOTE: We do not provide legal advice. If you are planning to file Due Process or are in Due Process, please consult an attorney.


Basic Information
Family Contact Information
Address Information
Release of Liability
Download the ASTra Release of Liability Form.

Print and complete the form and upload it below. Or check your confirmation email for email/fax/mail submission options.

Communication Preferences
How does your child prefer to communicate? (Select one or any combination).



Child's Access of Information
Describe the communication in your home and at school. Provide a description of communication/language used and any difficulties you see.
Child's Hearing Levels
Describe child's hearing levels.


















Amplification Usage
Child's Audiogram
Child's Education
Describe child's educational setting.
Grade Level Functioning

Indicate your child's functioning compared to grade level.

School Placement
Professionals Involved
Provide name and contact information for the professionals who are most familiar with and have the best understanding of your child and situation.
Advocacy Issues
Select all areas of concern according to priority of need.
Written Requests
Responses Received
Other Resources Being Used
Next Steps
CA Hands & Voices Membership
Our advocacy services depend largely on voluntary support. ASTra services are free to families, but your membership donation to the local Hands & Voices Chapter helps provide this type of support to families, and priority is given to members. If you'd like to join please complete a membership application following this form.
The local chapter will call/email to schedule a phone appointment with you within ten days of receiving this form. If you don’t hear from us, please call to confirm that the form was received. Please note our amount of support we can provide will be determined by the availability of our staff/volunteers. Meanwhile, see the following Hands & Voices websites for helpful information: Hands & Voices Headquarters.

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About CA Hands & Voices

California Hands & Voices is dedicated to supporting families with children who are Deaf or Hard of Hearing in a respectful and non-judgmental manner regarding language opportunities, communication tools or educational approaches. We’re a parent-driven, non-profit organization providing families with the resources, networks, and information to improve communication access and educational outcomes for their children.

Support ♥

California Hands & Voices is a non-profit organization that depends on the support of its members to succeed. Please consider donating or becoming a member.

Contact Us

 

California Hands & Voices
c/o Kat Lowrance
2844 Gunn Ct.
Redding, CA. 96001-5484, USA

 

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