GCPS Student Required Absence Note
Name of Student
Teacher
Parent/Guardian name
Parent/Guardian phone number
In the last 14 days, has your child experienced or currently experiencing any of the following symptoms?
Is your child experiencing any of the following symptoms that he/she does not normally experience?
Date that symptoms started
MM
/
DD
/
YYYY
Has your child had any known COVID contacts in the last 14 days?
Clear selection
Date of known exposure
MM
/
DD
/
YYYY
Has your child been tested for Covid since symptom onset?
Clear selection
Date of Covid test
MM
/
DD
/
YYYY
Covid test results
Clear selection
Has your child been seen by a doctor and given an alternative diagnosis?
Clear selection
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