The parent is responsible for completeing the Parent/Guardian/Adult Student section form (below) and the Medical Certification of Need Form (below).
Please complete all information on the parent section of the application (page 1) including an email address if available.
This form is to be completed and signed by a licensed physician or a licensed clinical psychiatrist/psychologist, including their current license number. All questions on this form have to be completed.
If your child has a mental health condition a signature is needed from the treating doctor’s office where there is a licensed psychiatrist or psychologist.
- IF your child has a physical condition the treating doctor’s signature is needed on the homebound form.
- If you child has both a mental health condition and a physical medical condition you will need both doctors signatures.