Get Pittsburgh Homebound Application

The Pittsburgh Homebound Application is a critical document for securing temporary educational services for students unable to attend school due to medical reasons. This guide will provide step-by-step instructions to assist you in completing the application accurately and efficiently.

Follow the steps to complete the application form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by providing the student's name and date of birth. Ensure this information is printed clearly to avoid any errors.
3. Indicate the reason for the extension of homebound instruction and remember to include a treatment plan if it is due to psychiatric reasons.
4. If the student is pregnant, enter the expected due date in the designated field.
5. Fill out the degree of disability and any medications or interventions that have been recommended for the student.
6. Specify whether the student can be assigned to a modified school program (half days or a modified week) by selecting 'Yes' or 'No'. If 'No', provide an explanation.
7. Provide an approximate date when the student can return to school. This date is critical for planning educational services.
8. Complete the physician's section by printing their name, signing the form, and including their contact information.
9. If applicable, complete the additional section for psychiatric disabilities, including the current level of treatment and any recommendations for hospitalization.
10. Review the entire form for completeness and accuracy before submitting.
11. Finally, save your changes, download a copy of the form, and decide whether to print or share it as needed.

Begin your application process online today.