Get the free Homebound School Referral Form Rev. 8-2016 - Health Services - healthservices ccs k1...

CUMBERLAND COUNTY SCHOOLS HOUSEBOUND INSTRUCTION School Referral Form Rev. 8/2016 Student Name: Student ID: Address: Age: City: DOB: Grade: NC Zip: Gender: Ethnicity: Parent/Guardian Name: Home Phone:

How to fill out homebound school referral form

Who needs homebound school referral form?

1. Students who are unable to attend school due to medical reasons or disabilities may require a homebound school referral form. This form is usually needed to obtain educational services and support while they are unable to physically attend school.
2. The homebound school referral form may also be necessary for students who are temporarily unable to attend school due to a specific illness or injury. This allows them to continue their education and receive academic support while recovering at home.

How to fill out homebound school referral form:

1. Begin by providing the student's personal information. This includes their full name, date of birth, and contact information. It is important to ensure accuracy when filling out this section.
2. Next, provide details about the student's school and grade level. Include the school name, address, and contact information. Specify the current grade or class that the student is enrolled in.
3. Explain the reason for the homebound request. Provide a detailed description of the student's medical condition, disability, or injury that prevents them from attending school. Use clear and concise language to convey the necessary information.
4. Indicate the expected duration of the homebound request. Specify the starting date and estimate the anticipated end date, if known. This will help the school administration plan and coordinate the student's educational services accordingly.
5. Include documentation or medical reports supporting the homebound request. Attach any relevant medical records, doctor's notes, or evaluations that validate the need for homebound schooling. These documents should clearly outline the student's condition and confirm their inability to attend regular school.
6. If applicable, mention any specific accommodations or services required for the student during their homebound schooling period. This may include access to educational materials, virtual learning platforms, or support from specialized professionals such as tutors or therapists.
7. Finally, make sure the form is signed and dated by both the parent/guardian and the healthcare provider responsible for overseeing the student's medical condition. Their signatures validate the information provided and authorize the request for homebound schooling.

Remember, it is essential to consult with the school administration or designated personnel to understand any additional requirements or procedures specific to your educational institution when filling out the homebound school referral form.

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What is homebound school referral form?

Homebound school referral form is a document used to request educational services for students who are unable to attend school due to medical or psychological reasons.

Who is required to file homebound school referral form?

Parents or guardians of students who are unable to attend school due to medical or psychological reasons are usually required to file the homebound school referral form.

How to fill out homebound school referral form?

To fill out the homebound school referral form, parents or guardians must provide information about the student's condition, the reason for homebound education, and any supporting documentation from a medical professional.

What is the purpose of homebound school referral form?

The purpose of the homebound school referral form is to request educational services for students who are unable to attend school due to medical or psychological reasons.

What information must be reported on homebound school referral form?

The homebound school referral form must include information about the student's condition, the reason for homebound education, and any supporting documentation from a medical professional.