Student Illness Report
If your student isn't feeling well please complete the following form, even if they have been treated. We want to better track illnesses in order to prevent spreading to other students or staff. Thank You
Date
MM
/
DD
/
YYYY
Student's FIRST Name
Your answer
Student's LAST Name
Your answer
Homeroom Teacher's LAST Name
Your answer
Grade Level
Parent's/ Guardian's Name
Your answer
Phone number
Your answer
Email
Your answer
Comments (symptoms)
Your answer
Submit
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