CIMC Infant Registration (birth through age 2)

Welcome to the CIMC page for Early Intervention service providers. Please use the registration form below to register every student (birth through age 2) receiving vision services.

NOTE:  As of November 20, 2019, we are working on a new and improved Infant Registration form. We will post the new form as soon as it is tested and ready to use.  If you need to register an infant immediately, please email us and we will work with you to make that happen. 


If you want the CIMC to include your infant in the Federal Quota Census (of legally blind students) managed by the American Printing House for the Blind (APH), please submit a signed Parent Consent Form (English) Parent Consent Form Spanish.

You are required to have an updated eye report, indicating current acuity OR  a completed MDB/FDB form signed by an Optometrist or Ophthalmologist on file.

Exit form

Note: If you are registering a preschool student 3 years of age or older, please use the registration form on the CIMC student registration page of the website.