There are two forms that must be completed and submitted to the building representative or school guidance counselor to certify homebound services.
- Form A to be completed and signed by the parent
- Form B to be completed by the child's physician
Extension of Homebound Services
Homebound instruction is intended to be a temporary service. Requests for homebound instruction extending beyond nine weeks (or 45 days) requires the following form:
- Form C- Physician Transition Plan (Medical Certification of Need)
It is the responsibility of the parent or guardian to provide this information to the school guidance counselor or school consulting teacher. Homebound instruction can not be extended without this required documentation.
Forms A and B
Link to VDOE Homebound Guidelines