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Absence Report -
Santa Rita School, Los Altos CA
Please fill out the following information to report your student's absence.
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Email
*
Your email
Student's First and Last Name:
*
Your answer
Teacher's Name and Grade Level:
*
Your answer
Your Name and Relationship to Student:
*
Your answer
Date(s) of absence, month and day:
*
Your answer
Reason(s) for the Absence (check all that apply):
*
Fever (99.6 degrees F or greater)
Chills, muscle or body aches
Runny nose/congestion only (no other symptoms)
Shortness of breath/difficulty breathing
Cough/sore throat
Unexplained headache (i.e. not a migraine)
Nausea, Vomiting and/or Diarrhea
Stomach ache (without nausea, vomiting or diarrhea)
COVID-19 positive test
Other contagious illness requiring follow-up
Medical Appointment (Please give us an idea what time your child will be at school in the note field below)
Vacation/Trip
Travel between 5-15 school days-Contact office to request an ISP at least 10 school days before travel starts.
Other (see below)
Required
If you selected "Other" above, please indicate reason for the absence:
Your answer
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