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Absence Verification
Thank you for reporting your child absent from school.
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* Indicates required question
Email
*
Your email
Student's First & Last Name
*
Your answer
Date of Absence
*
MM
/
DD
/
YYYY
Relationship to Student
*
Mother
Father
Stepmother
Stepfather
Other:
Reason for Absence
*
Student is ill
Doctor/Dentist Appointment (note required when student returns to school)
Funeral
Out of town
COVID
Other:
Illness Symptom Checker - Please check all applicable symptoms. Students may not return to school until 24 hours of being symptom-free without medication.
*
Fever above 100.4
Chills
Congestion
Runny nose
Cough
Shortness of breath or difficulty breathing
Nausea
Vomiting
Diarrhea
Excessive fatigue
Headache
Sore throat
Muscle or body aches
New loss of taste or smell
Rash
Red or irritated eyes
Conjunctivitis/Pink Eye
Other:
Required
Electronic Signature
*
Your answer
Send me a copy of my responses.
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