Bishop Woods Student Absence Form

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Bishop Woods Student Absence Form - (Excused Absence)

Email *

Date/Fecha *

YYYY

Student Last Name/Apellido *

Student First Name/Primer Nombre *

Student ID (Lunch #) - If known/Numero de Identificacion

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 *

Relationship to student/Relación con el estudiante *

Mother

Father

Grandparent

Guardian

Other:

Best contact phone #/ Mejor número de contacto *

Questions or Comments/ Preguntas o comentarios

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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