Get Homebound Instruction Medical Certification Of Need - Mcps

The Homebound Instruction Medical Certification Of Need - Mcps is an essential document for students requiring temporary homebound services due to physical or psychological conditions. This guide provides clear, step-by-step instructions to help you fill out this important form online with ease and accuracy.

Follow the steps to complete the Homebound Instruction Medical Certification Of Need - Mcps online.

1. Use the ‘Get Form’ button to access the form and open it in the appropriate online editor.
2. In the 'Name of Student' field, clearly enter the full name of the student receiving homebound services.
3. In the 'Date of Birth' section, accurately input the student's date of birth, ensuring the format fits the requirements.
4. Describe the diagnosis and conditions that indicate the need for extension of homebound services in the provided space. Include relevant details to support the request.
5. For the transition plan, specify any suggestions and accommodations needed to facilitate the student’s return to classroom instruction.
6. Outline any physical restrictions the student may face during the extended homebound instruction.
7. Indicate the recommended dates for the extension to begin and end in the specified sections.
8. The form must be signed by a licensed physician, clinical psychologist, or psychiatrist. Ensure that the printed name and date of signing are also included.
9. Provide the physician's address and telephone number, along with the type of practice.
10. A parent or guardian must also sign and date the form to confirm acknowledgment and agreement before submission.
11. Finally, submit the completed form to your child’s home school or fax it to the MCPS Student Services at the provided telephone number.

Complete the Homebound Instruction Medical Certification Of Need - Mcps online today!