Daily Student Absence Form For Illness
Parents please complete DAILY all questions on the form and complete the form individually for each student being reported absent. Thank you.
Student Last Name *
Student First Name *
Will your student be participating in virtual instruction today? *
Student's Grade *
Elementary Student's Homeroom Teacher
Is your student at home due to close contact with an individual testing positive for COVID-19 in the last 14 days? (quarantine) *
Has your student been diagnosed with COVID-19 by a health care provider in the last 10 days? (isolation) *
Is your child at home waiting for COVID-19 test results? *
Please check all the symptoms that your student has experienced in the last 24 hours: *
Does your student ride the bus? *
Guardian Last Name, First Name *
Guardian Cell Phone Number *
Is there anything else you would like to share with us?
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