Absence
Absence Form
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Child's name
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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.
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Person Submitting
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Dates of Absence
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Best contact information or additional information
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