Absence Verification
Enter Student's Name Below *
Date of Absence *
MM
/
DD
/
YYYY
Relationship to Student *
Required
Reason for Absence *
Required
Illness Symptom Checker- please complete if checked "Ill" above. Check all symptoms that apply. Students may not come back to school until 24 hours symptom free without medication. Please see the Keep Sick Children Home form on our website. *
Required
Electronic Signature *
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