HAMPTON CITY SCHOOLS APPLICATION FOR HOMEBOUND INSTRUCTION 2026

1. Click ‘Get Form’ to open the HAMPTON CITY SCHOOLS APPLICATION FOR HOMEBOUND INSTRUCTION in the editor.
2. Begin by filling out the student’s information in Part 1, including their name, sex, age, grade, and student ID number. Ensure accuracy as this information is crucial for processing.
3. Complete the address and parent/guardian details in Parts 3 and 4. This section helps establish contact and verify residency.
4. For physicians, proceed to Parts 6 through 15. Fill in the diagnosis without using insurance codes, and provide a detailed treatment plan that outlines how the student will return to school.
5. In Part 11, indicate whether the student is complying with the treatment plan. This is essential for assessing eligibility for homebound services.
6. Finally, ensure that both the parent/guardian and school designee sign where indicated. This confirms acknowledgment of the request for homebound services.

Start your application today using our platform for free and ensure a smooth process for homebound instruction!