NSSD Mission

NSSD Foundation

North Sanpete School District
Statement of .............

Board Policy with Guidelines

Policy Number:  VI-29
Effective Date:  03/10/1987
Revised Date:
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Subject:  Homebound Instruction

Homebound instruction shall be provided to any child with a health or physical impairment which, in the opinion of a licensed medical examiner, will cause him/her to be absent from school for more than two consecutive weeks and who school personnel determine can educationally benefit from such a program, or to any child whose educational needs, as determined by a case study and reviewed in a multidisciplinary staff conference, are most appropriately and effectively met by such a program.


  1. Parents of students who may qualify for homebound or hospital instruction will be asked to have a physician complete and sign a statement that it is anticipated that the student will be absent from school for the required period and that he or she is able to receive instruction. The completed form is to be sent to the principal who will arrange for a tutor.
  2. The tutor may be the student's regular teacher or another qualified person. If the tutor is a person other, than the student's classroom teacher, periodic conferences shall be established between the tutor and appropriate school personnel to coordinate courses of study. The tutor is paid by the school district and partial reimbursement from the state is claimed.
  3. A child who requires home or hospital instruction on a temporary basis shall be provided with instructional services sufficient to enable him/her to return to school with a minimum of difficulty Direct instructional time shall not be less than two hours per week.
  4. A child who requires home or hospital instruction for an extended period shall be provided with instructional services sufficient to advance his/her basic educational development appropriately.
  5. Instructional time shall he scheduled only on days when school is regularly in session.


Student's Name________________________________________ Room Number____________________

Parent's Name _________________________________________ Address ________________________

Nature or Illness or Injury _________________________________________________________________

Date of Incapacitation _________________________

Date of Request for Homebound Aid __________________________

Teacher Assigned ________________________________________  Date ________________________

Date Time of Visit Hours Rate/Hr. Salary Round Trip Miles Rate/Mile Total

Transfer and reentry has been made on roll book: Yes ____ No ____

Give date of each school day student was incapacitated whether visit was made or not.