Absence Form - SMKCS '20-'21
Please complete this form each day that your child is absent before 8:30 am.
If you are unsure about your child returning to school, please consult with your pediatrician. Following an illness or consultation of symptoms, a doctor's note is recommended, but not required.
Date of Absence
Child's Homeroom Teacher
Symptoms that my child is experiencing:
Fever or chills
Shortness of breath
Muscle or body aches
New or unexplained loss of taste or smell
Congestion or runny nose
Nausea or vomiting
Has anyone else in your household experienced any of the above symptoms? Please explain.
Has your child or anyone in your home tested positive for COVID-19?
Tested and waiting for results
Length of absence
1-2 school days
3-4 school days
5 or more school days
Partial Day Absence
Additional information regarding your child's symptoms or absence:
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This form was created inside of St. Mary of the Knobs Catholic Church.