Estabrook Absence Form

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If your child is not feeling well, DO NOT send them to school. We appreciate your help in keeping everyone safe!

Please complete this form if your child will be ABSENT. You may also call Estabrook's main office at 781-861-2520.

If you have any questions, please contact the nurses at est-nurse@lexingtonma.org

Email *

Student First Name *

Student Last Name *

Grade *

Teacher *

Date of Absence *

Reason for absence

Does your child have any of the following symptoms? *

Fever (100 degrees Fahrenheit or higher)

Chills/shaking chills

New Cough (not due to other known cause, such as a chronic condition)

Difficulty breathing/shortness of breath

New loss of taste or smell

Sore throat

Headache

Muscle aches or body aches

Nausea

Vomiting

Diarrhea

Fatigue/tiredness

Nasal congestion/runny nose

Not applicable

Required

If you check off any of the above symptoms/scenarios, is your child being tested for Flu, Strep, or COVID? *

Yes

Not applicable

Did your child test positive for... *

Strep

Flu

COVID

N/A

Required

Please provide your name & phone number should we need to follow up with you *

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

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