Absence Reporting
Parent/Guardian Information
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Email *
Parent/Guardian Last Name *
Parent/Guardian First Name *
Contact Number (###) ###-#### *
Phone number where we can reach you:
Student Information
It is important that you report your child’s absence/tardy/early dismissal and click any symptoms that they are experiencing.
Student Last Name *
Student First Name *
School *
Grade Level *
Date of Absence/Tardy/Early Dismissal *
If this applies to a range of days, use this for the start date.
MM
/
DD
/
YYYY
Ending Date
If, applicable, on what date will the absence end?
MM
/
DD
/
YYYY
My child will be: *
Reason for Absence/Tardy/Early Dismissal: *
Please be specific with description or diagnosis and select any symptom that your child is experiencing (this information will remain confidential). In the case of Tardy/Early Dismissal, please be specific with the times. ***In the event you were notified that your child should remain home due to a COVID related matter, but will complete their school work and engage in teacher support hours, please specify that below. Your child will be marked as QUR (Quarantining for the day), and their attendance will not be penalized.***
Symptoms *
Required
Symptom Start Date
If, applicable, on what date did these symptoms begin?
MM
/
DD
/
YYYY
If absent due to travel, are you travelling OUTSIDE of the contiguous United States? *
A copy of your responses will be emailed to the address you provided.
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