Absence Form
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Child's / Children's name(s) *
Reason for Absence (If sick, please list symptoms and/or doctor's diagnosis) If the reason for the student’s absence is related to COVID-19 symptoms, such as a fever, cough, shortness of breath, new or recent loss of smell or taste, sore throat, or nausea and/or diarrhea, please specify these symptoms so a Registered Nurse may contact you for follow-up. *
Person Submitting *
Dates of Absence (Please list all dates your student will be gone) *
Best contact information or additional information
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