• The parent is responsible for completeing the Parent/Guardian/Adult Student section form (below) and the Medical Certification of Need Form (below).  

    Page 1- Parent/Guardian/Adult Student (18 & up) Section: (Part I) (click here)

    Please complete all information on the parent section of the application (page 1) including an email address if available.


    Pages 2-3 - Medical Certification of Need: (Part II) (click here)

    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.