Winslow Elementary School- Student ILLNESS related Absence Reporting

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Please use this form to report your child's absence for illness only. A member of the nursing team may contact you directly to gather more information. Please call the WES main office at #872-1967 to report absences that are unrelated to illness.

Email *

Option 1

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Date of Absence *

YYYY

Student's Name (if reporting more than one, please use a different form for each student): *

Student's Grade

Who is filling out this form and what is the best phone number to reach you? *

Please check any symptoms that your child is having or reasons for absence: *

Cough

Shortness of breath or difficulty breathing

Fever (100.4 or greater)

Sore throat

New loss of taste and/or smell

Nausea, vomiting or diarrhea

Fatigue

Headache

Congestion or runny nose

Mental health related

Required

Any additional information about your child's absence

A copy of your responses will be emailed to the address you provided.

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