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Student/Staff Absence Form
Please complete this form if you or a student will be absent from school for any reason.
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* Indicates required question
Name of Absentee:
*
Your answer
Class:
*
Your answer
Reason for Absence:
*
Sick
Not sick (personal time, appointments, etc)
Vacation (If checked, please list dates in last section)
If sick, please list symptoms (check all that apply):
Fever
Headache
Sore throat
Runny nose/Congestion
Cough
Shortness of Breath
Nausea/Vomiting
Diarrhea
Abdominal Pain
Loss of Taste/Smell
Fatigue/Exhaustioin
Body Aches
Chills
Other:
Anything Additional to Share?
Your answer
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