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Medically Necessary Instruction

Medically Necessary Instruction provides educational services for all school-aged children (grades 3-K to12) who are unable to attend school due to orthopedic, non-orthopedic/medical, or psychiatric reasons.

  • This program serves students in all five boroughs of New York City.

  • It is an interim, non-diploma granting program.

  • The instruction provides academic services to limit the educational effects of a long-term absence (four weeks or more).

  • The Medically Necessary Instruction operates during the day and after-school hours.

NOTE: Social Security Number is not required for HIPPA




Submit a Request for Medically Necessary Instruction

In order to request Medically Necessary Instruction Services, the parent/guardian of the student must notify the school’s guidance counselor and work with the school of affiliation (“home school”) to submit a complete application including all four of the following forms:

  1. Authorization for Release of Medical Records (HIPAA Form) to be completed by Parent /Student

    • Complete the top portion of the form with patient (student) name, address, and date of birth (DOB).

    • Leave box numbers 7 and 8 blank, unless you wish to limit the medical information provided to the DOE. Please note that narrowing the authorization could lead to delays in reviewing and/or approving the application.

    • Complete Box Numbers 10 and 11 only if appropriate.

    • Sign and date the form.

      • Please note that if the student is 18 years of age or older and able, they MUST sign the form themselves

  2. Home Instruction Referral Form: to be completed by the student’s home school

    • High school students must also submit their permanent record, program, and transcript.

  3. Home Instruction Medical Referral Form: to be completed by a physician.

  4. Family Request Form for In-Person Services in Medical Necessary Instruction: to be completed by a parent.

Send this completed package to or fax them to (718) 472-6113.

Forms and Translations can be found on the NYC DoE website.

Important Information

  • Be sure you complete ALL pages in the application.

  • Submitting application materials does not ensure approval for services.

  • To avoid delays in the application process, please make sure that all applicable information is completed.

  • All referrals for psychiatric reasons must be made by a PSYCHIATRIST.

  • Send this completed package to or fax them to (718) 472-6113.

  • Medically Necessary Instruction is not available for students who cannot attend school because they have not met immunization requirements. Families should contact the Office of Home Schooling for additional information at

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