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BUL 1229.2 LOS ANGELES UNIFIED SCHOOL DISTRICT Educational Options January 22, 2010 Page 1 of 2 ATTACHMENT A Carlson Home Hospital School 10952 Whipple St. No. Hollywood, CA 91602 Phone: (818) 5098759.

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How to fill out the Carlson Home Online Academy online

Filling out the Carlson Home Online Academy form is an essential step for securing home instruction services for students. This guide provides clear, detailed instructions to help users navigate the process effectively.

Follow the steps to complete the form with ease.

  1. Click ‘Get Form’ button to obtain the form and open it for editing.
  2. Enter student information in the provided fields, including the student's name, date of birth, grade, and primary language.
  3. Fill in the address, main contact phone number, and optional contact numbers for additional guardians or family members.
  4. Indicate the name and language of the parent or guardian, along with the cumulative record carrying school and its contact information.
  5. Specify the student's last date of attendance at school and whether the student has a current Individualized Education Program (IEP) or 504 Plan.
  6. Review the 'Implementation of Service' section, which outlines the commitment to providing home instruction, and the conditions under which instruction will take place.
  7. In the authorization section, have the parent or guardian provide their signature and the date to grant permission for services.
  8. Proceed to page two, where a California licensed physician must complete the necessary medical assessment to authorize service.
  9. The physician will document the diagnosis and summarize the medical issue. They should note any necessary restrictions related to the student’s condition.
  10. Include the physician's signature, printed name, and contact information before finalizing the form.
  11. Once all sections are completed, save the changes to the form. You may choose to download, print, or share the document as required.

Complete the Carlson Home Online Academy form online today to begin accessing essential educational support services.

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