Can’t find the template you need? Request a template and I’ll make it in Word, free.

Get new free printables first: follow Word Made Easy on Pinterest

These free home visitation form templates give you 3 designs as Word documents on long bond (8.5 x 13 in) and A4: a home visitation form, a home visitation log for the class and a home visitation plan, each in colour and in black and white. Every template is human-made by a teacher: I’m Patrick Elliott, a teacher and Inclusion Lead, and I designed and built each one myself in Microsoft Word, then printed them to check they line up and fill the page as they should.

In this guide, you’ll find what goes on a home visitation form, which template to use, and how to fill it in during the visit.

---

---

What’s in the Home Visitation Form Templates

Paper	Template	Best for
Long bond (8.5 x 13)	Home Visitation Form	Purpose, findings, agreements and signatures for one visit
Long bond (8.5 x 13)	Home Visitation Log	Every visit for the class on one page
Long bond (8.5 x 13)	Home Visitation Plan	Plan the month’s visits and tick them off
A4	Home Visitation Form	Purpose, findings, agreements and signatures for one visit
A4	Home Visitation Log	Every visit for the class on one page
A4	Home Visitation Plan	Plan the month’s visits and tick them off

👉 Click any line or box and type, tick the purpose boxes, and the notes rows grow if you write more.

---

What Is a Home Visitation Form?

A home visitation form records a class adviser’s visit to a learner’s home: why you went, who you met, what you found and what you agreed with the family. Schools use home visits for frequent absences, falling grades, behavior or health concerns and learners at risk of dropping out. There is no official national form, so division and school forms vary; most have the learner and parent details, a purpose checklist, remarks or agreements, and signatures of the adviser, the parent or guardian and a “noted by” line for the guidance counselor or school head. These templates follow that layout. They are independent templates from Word Made Easy, not official DepEd documents, so they carry no DepEd seal: add your school’s name and logo if your division asks for them.

---

Which Home Visitation Template Should You Use?

• Home visitation form: one visit on one page: learner, LRN, parent or guardian, address, purpose tick boxes, persons met, findings, concerns, agreements, a follow-up date and three signatures.
• Home visitation log: every visit for your class on one landscape page, for your records or your school head.
• Home visitation plan: plan the month’s visits by learner, barangay and purpose, then tick each one off.
• Keep factual notes on what led to the visit with the anecdotal record templates.

---

How to Fill In the Home Visitation Form

1. Before the visit, fill in the learner and parent details and tick the purpose of the visit.
2. During the visit, write the names of the people you met and what you observed.
3. Note any concerns the family raises, in their words where you can.
4. Agree on next steps together and write them under Agreements and action plan, with a follow-up date.
5. Ask the parent or guardian to sign, sign it yourself, then give it to your school head or guidance counselor to note.

Fill in the form with the family, not after you leave, so the agreements are clear to everyone. Keep the forms confidential: they hold personal information about the learner and family.

---

Black and White Versions

Every template on this page also comes in a black and white version with the same layout: grey headings and an outlined title, so it prints clearly on any printer and saves ink. In the download box, choose Long bond or A4 for the colour files, Black and white for the black and white files on both papers, or Everything for all of them.

---

How to Print at the Right Size

1. Open the template in Word and press Ctrl + P (Cmd + P on a Mac).
2. Choose the paper size in the file name: long bond (8.5 x 13 in) or A4.
3. Set scaling to 100% or Actual size, not Fit to page.
4. Print one sheet and measure a row with a ruler before you print a class set.

Every sheet keeps a 1/2 inch (12.7 mm) margin on all sides, so nothing is cut off on home inkjets, school laser printers or older printers with a wide edge.

---

FAQs

---

Conclusion

These home visitation forms keep every visit clear and on record, human-made by a teacher in Microsoft Word.

Choose your paper size above, download the ZIP, and to note what you see in class, use the anecdotal record templates.

---

Related Tutorials

• Free Anecdotal Record Templates for Word
• Free Intervention Log Templates for Word
• Free IEP Templates for Word