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HOUSEBOUND SERVICES REQUEST Form be completed by parent/guardian: I am requesting home bound services for my child. I will provide medical documentation of this need and will assure that an adult

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How to fill out parent request for homebound

01

Obtain the parent request for homebound form from the relevant educational institution or district office.

02

Fill out all required personal and contact information, including the student's name, date of birth, and current grade level.

03

Provide a detailed explanation as to why the student requires homebound services. This explanation should include any medical conditions, disabilities, or other circumstances that prevent the student from attending school in a traditional setting.

04

Attach any supporting documentation, such as medical records, doctor's notes, or evaluations, that can substantiate the need for homebound services.

05

Sign and date the form, indicating your consent for the educational institution to review and process the request.

06

Submit the completed form and any accompanying documents to the appropriate department or office as instructed.

07

Follow up with the educational institution or district office to ensure that your request has been received and is being processed.

Who needs parent request for homebound?

01

Any student who is unable to attend school in a traditional setting due to medical conditions, disabilities, or other circumstances may need a parent request for homebound services.

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