Homebound instruction form - Greenville County School District 2025

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  1. Click ‘Get Form’ to open the Homebound instruction form in the editor.
  2. In Section I, enter the student’s name, date of birth, school, school district, age, and grade. Ensure that this section is completed by school personnel upon request from a parent or guardian.
  3. Proceed to Section II where a licensed physician must provide a complete diagnosis, prognosis, treatment plan, and educational impact. Dates for nonattendance should be specified based on the treatment plan.
  4. In Section III, the parent or guardian must sign and date to authorize the release of medical information. If the student is over eighteen, they may sign instead.
  5. Leave Section IV blank for the Homebound Coordinator to complete after submission.

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CMS has said that a patient is usually considered homebound if leaving home is medically contraindicated or if the patient has a condition that restricts his or her ability to leave home without a supportive device (e.g., crutches, cane, wheelchair, walker), special transportation or the assistance of another person.
Search this Topic Search Back to All Topics. Medicare considers you homebound if: You need the help of another person or medical equipment such as crutches, a walker, or a wheelchair to leave your home, or your doctor believes that your health or illness could get worse if you leave your home.
Homebound school services start being implemented. Instructions are typically delivered twice a week at the students home, hospital, or another medical facility. These include one-on-one instructions in core subjects, assignments, and assessments. The process is facilitated and supported by the family.
A request for homebound instruction will only be considered if the application states that the student will either be out of school for 10 or more consecutive school days, or if the intermittent accumulation of absences over a 30 day period will be more than 15 days.
Homebound education is an educational service designed for students who are unable to attend school for extended periods due to medical, psychiatric, or behavioral needs, as well as for those who are suspended or incarcerated.

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To be considered homebound: A patients medical condition restricts the ability to leave home without assistance from another individual or a supportive device, OR the patients medical condition restricts the ability to leave home.
And dont be confused by the term home instructionthis means children who are home-schooled. This document does not address home schooling. homebound instruction be available to students are confined at home or in a health care facility for a period of time and cannot attend school.
The primary qualifications for becoming a homebound teacher are a bachelors degree in a relevant field and a special education teacher certification.

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