• Iredell-Statesville Schools
    Homebound Packet
    It is the mission of Iredell-Statesville Schools to rigorously challenge all students to achieve their academic potential and to lead productive and rewarding lives. We will achieve this mission with the support of parents, staff, and the community. Iredell-Statesville Schools believes that every student can learn and deserves rich classroom instruction. The district realizes that some circumstances arise where homebound instruction is necessary in place of attending regular school. With that being said, many studies have been performed on school attendance and student achievement, and the results are not surprising "...student test performance is better when class attendance is better and students with better attendance demonstrate more knowledge of the course materials" (Ledman and Kamuche, 2002).
    It needs to be recognized that the student will get the best education while being at school and not at home. The homebound program is one way Iredell-Statesville Schools is attempting to meet the educational needs of all its students. If a student is expected to miss school no more than (2) two weeks (high school) or (4) four weeks (elementary or middle school), the school site should manage assignments, this would not be considered homebound. The expectation is for students, that would be eligible, to receive homebound on an "as needed basis". If a student is expected to miss more than the allotted time, she/he would be eligible for homebound services by completing the appropriate referral form. If the student is a student with an Individualized Education Program (IEP), please contact the Coordinator of Disability Services at ADR. If homebound services will last more than 12 weeks, a new homebound referral form will need to be completed upon re-evaluation by the supervising physician. The school team will review the continued need for homebound every 30 days. If the student has an IEP, the IEP Team will review the need for continued homebound services through the IEP process. Information that is needed to enroll your student in the homebound program is found in the Homebound Packet. Please make sure that all forms are complete or delays in the processing may occur.
    Click here to download the entire packet. To view or download particular pages and/or forms, see the individual links below.
     Table of ContentsFile Number 
     Contact Information and Paperwork Needed for Homebound Process 1
     Homebound Services/Instruction Information FormHB Form 1
     Parent Authorization for Homebound Services/InstructionHB Form 2
     Physician's Referral for Homebound Services/Instruction 
    HB Form 3
     Physician's Referral for OB/GYN DiagnosisHB Form 4
     Psychiatrist's Referral for Homebound Services/InstructionHB Form 5
     Homebound Teacher ContractHB Form 6
     Survival Guide for Teacher 2
     Class Assignments from Class InstructorHB Form 7
     Class Assignments from Homebound TeacherHB Form 8
     Summary of ProgressHB Form 9
     Teachers of Homebound StudentsHB Form 10
     Home Visit Record/Attendance LogHB Form 11
     Homebound Review FormHB Form 12 
     Information Exchange Release FormHB Form 13 
Last Modified on September 9, 2016