Therapy Schedule Update
Parents: Please complete this form for PLANNED DAYS OFF (vacations, appointments, etc.)

For unexpected days off, such as illness, please call the attendance line: 810-344-8082, ext. 1 for Brighton, ext. 2 for Burton.

Each year your child is allowed 12 days of unexcused absences.
Unexcused absences include calling in sick or cancelling a session with less than 2 weeks’ notice.

Excused absences include scheduled absences with more than 2 weeks’ notice, or calling in sick and providing a doctor’s note.
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Email *
Which center does your child attend? *
Child's first name *
Name of caregiver completing form *
Please indicate reason for absence: *
Dates of absences *
Total number of days absent (can use half days) *
Date returning to therapy: *
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