We will not pursue reimbursement from Medicaid without your informed consent.
Click here for the form in English. For other languages see below.
The Diagnosis Form is simply a request for information by HIDOE to acquire a student’s medical diagnosis(es) as determined by a physician. Parents/Guardians may complete this form if they know the information. If not, ask your child's physician to complete it.
Many families are Medicaid-eligible but don't enroll because they don't believe they qualify.
Let other families know about what we are doing for our students and schools. Use the resources below so that we can reach as many people as possible.
Medicaid reimbursement provides HIDOE with additional funding that can be put towards educational activities and services. These funds ultimately go back to HIDOE and its students.
Parent Consent Form Instructions