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Student NameStudent IDWeekDate of ContactReason for Call
Check all that apply.		Phone Call (preferred)Email/Talking PointsNotes: Include all relevant details.Alerts (must fill out notes)ADMIN/Care Team Only
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Not attending live class
Not submitting assignments
Not participating in Canvas Course
No answer,
unable to leave message
No answer, left message
No working numbers
Spoke with parent/guardian
No response
Received response
Contact info not valid


Examples:
Who did you speak with?
Concerns shared by parent/guardian?
If you used a translator, indicate translator's name.
Record any new contact information given.
Flag for Admin follow up
Flag for Care Team follow-up
Indicate when follow-up occured.
Please initial.
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