Get Certification For Need For Homebound Instruction - Henrico County ...

Filling out the Certification For Need For Homebound Instruction is an important step for students needing homebound services in Henrico County. This guide provides a clear and supportive roadmap to ensure that users can complete the form accurately and efficiently.

Follow the steps to successfully complete the form.

1. Click the ‘Get Form’ button to obtain the form and view it in your chosen editor.
2. Begin by entering the student's full name, date of birth, grade, and home school in the designated fields. Ensure the information is accurate to avoid any issues.
3. Input the date of examination or diagnosis. Indicate whether the student is confined at home or in a health care facility by checking 'Yes' or 'No'.
4. Describe the nature and extent of the illness in detail. This information is crucial for determining the need for homebound instruction.
5. Indicate if the illness/treatment is intermittent in nature. If applicable, specify any necessary accommodations that would allow the student to attend school.
6. If the student cannot attend school without accommodations, provide a detailed treatment plan as required, including frequency and duration.
7. Fill in the estimated date of return to school. This helps the school plan for reintegration.
8. Have the licensed physician, clinical psychologist, or psychiatrist print and sign their name, along with their office address, telephone number, and email address.
9. Next, the parent or guardian should complete their section. Fill in the name, address, and phone numbers accurately.
10. Read through the acknowledgment and release statements carefully. Sign and date where indicated.
11. Review the completed form to ensure all sections are filled out thoroughly. Save changes, then download or print the form for submission.

Start filling out your Certification For Need For Homebound Instruction online today.