Bishop Woods Student Absence Form - (Excused Absence)
* Required
Email address
*
Your email
Date/Fecha
*
MM
/
DD
/
YYYY
Student Last Name/Apellido
*
Your answer
Student First Name/Primer Nombre
*
Your answer
Student ID (Lunch #) - If known/Numero de Identificacion
Your answer
Please indicate whether your child has any of the following symptoms. If none of these symptoms are present, please indicate so by checking the last box./ Indique si su hijo tiene alguno de los siguientes síntomas. Si no presenta ninguno de estos síntomas, indíquelo marcando la última casilla.
*
Shortness of breath
Cough
Fever
Chills
Headache
Repeated shaking with chills
Muscle pain
Sore throat
Loss of taste or smell
No symptoms listed above
Required
Adult completing the form/ Adulto completando formulario
*
Your answer
Relationship to student/Relación con el estudiante
*
Mother
Father
Grandparent
Guardian
Other:
Best contact phone #/ Mejor número de contacto
*
Your answer
Questions or Comments/ Preguntas o comentarios
Your answer
Based on your child's symptoms, our school nurse may be contacting you with more information and/or to discuss next steps. / Según los síntomas de su hijo, nuestra enfermera escolar puede comunicarse con usted para brindarle más información y / o discutir los próximos pasos.
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