Student Absence Health Screening

The safety and well-being of our faculty, staff, students, and families has always been our top priority, and that takes on special significance in light of the outbreak of COVID-19. Bishop Thomas’ Restoration Advisory Council has been working diligently these past few months to create a plan where employees, students, and families feel safe in our return to school.

Our records indicate that your child is out sick today. Please take a moment to let us know the reason for absence, and the expected duration of the absence.

**This information will be held confidentially in the school nurse's office.**
Date the Student was absent? *
MM
/
DD
/
YYYY
Student Name *
Student Grade *
Required
Since your last time on campus, have you had any two of these symptoms? Check all that apply. *
Required
Additional Parent Comments with anticipated date of return - required if "none of the above" to explain absence. *
Please note: If your child has at least two symptoms of COVID-19, a doctor's note must be provided with return to school date if other than COVID-19. If the student does not go to the doctor, a student with symptoms must stay home for 14 days from the onset of symptoms.
**If your child has a fever, they must be fever free without medication for 72 hours.**
Does your student live with any other students that attend school? *
If yes above, please detail with name/grade/school
Has your student been in close contact with a person lab confirmed to have COVID-19? If yes, please contact Mrs. Palacio at 702-732-4477 x134 or apalacio@stviator.org *
Completed by: *
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