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APPLICATION FOR HOUSEBOUND INSTRUCTION Intervention Services APPLICATION FOR APPROVAL OF HOUSEBOUND INSTRUCTION Medical/Behavioral Needs Referral Students Name: School: Home bound Coordinator : Teacher(s):

How to fill out application for homebound instruction

How to fill out an application for homebound instruction:

1. Obtain the necessary forms: Contact your local school district or education department to request the application for homebound instruction. They should provide you with the appropriate forms and instructions.
2. Fill in personal information: Start by providing your name, address, contact information, and any other required personal details. This information will help the school district identify you and process your application.
3. Explain the reason for homebound instruction: In this section, clearly state the reason why you are seeking homebound instruction. It could be due to a medical condition, disability, temporary injury, or any other circumstances that prevent you from attending school in person.
4. Include supporting documentation: Attach any relevant documents or medical records that support your request for homebound instruction. These may include doctor's notes, hospital discharge summaries, or any other proof of your condition.
5. Specify the requested duration: Indicate the estimated duration for which you expect to require homebound instruction. This could be a specific period or until a certain condition is resolved. This helps the school district determine the appropriate plan for your education.
6. Include educational goals and requirements: Outline the educational goals you wish to achieve while receiving homebound instruction. This helps the school district plan the curriculum and assign appropriate teachers or tutors to facilitate your learning.
7. Provide contact details for your healthcare provider: Include the contact information of the healthcare professional treating your condition. This allows the school district to communicate with them if needed, to verify your need for homebound instruction.

Who needs an application for homebound instruction?

1. Students with medical conditions: If a student has a medical condition that prevents them from attending school, they may need to submit an application for homebound instruction. This ensures they can receive education while at home.
2. Students with disabilities: Some students with disabilities may require homebound instruction due to the nature of their condition. An application is necessary to establish the need and provide appropriate accommodations.
3. Students with temporary injuries: In case of temporary injuries, such as fractures or surgeries, students may need to apply for homebound instruction until they are physically able to attend school again.
4. Students with contagious illnesses: If a student has a contagious illness, they may need to apply for homebound instruction to prevent spreading the illness to others at school.

Overall, anyone who cannot physically attend school due to a valid reason and wishes to continue their education should submit an application for homebound instruction.

For pdfFiller’s FAQs

What is application for homebound instruction?

Application for homebound instruction is a form that must be filled out by students who are unable to attend school due to illness or injury.

Who is required to file application for homebound instruction?

The student's parent or guardian is required to file the application for homebound instruction.

How to fill out application for homebound instruction?

The application for homebound instruction can typically be obtained from the student's school or school district, and must be completed with relevant information about the student's condition and need for homebound instruction.

What is the purpose of application for homebound instruction?

The purpose of the application for homebound instruction is to formally request that the student be provided with educational services while unable to attend school in person.

What information must be reported on application for homebound instruction?

The application for homebound instruction typically requires information such as the student's name, grade level, reason for needing homebound instruction, healthcare provider's recommendation, and duration of homebound instruction needed.

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