This attendance form is to be submitted by the parent/legal guardian only.
Please check this box if you wish to report consecutive day absences.
Please list the specific consecutive dates of the absence.
Please be specific about the reason why your child will not be attending school today. In the "Reason for Absence/Late Arrival" blank space on the form above, indicate whether your child has any of the following symptoms:

  • Feeling feverish or chills
  • Fever greater than or equal to 100.4 F
  • Headache (not due to another health condition, hunger, menstrual cramps stress, or injury)
  • A new cough (not due to another health condition)
  • Shortness of breath or breathing difficulties (not due to diagnosed respiratory condition or if different than normal pattern of chronic condition)
  • A new sore throat (not due to another health condition)
  • Congestion or runny nose (not related to allergies or health condition)
  • Fatigue (more tired than normal or sudden onset)
  • New muscle pain (not due to another health condition or that may have been caused by a specific activity such as physical exercise))
  • New loss of taste, smell, or appetite
  • Abdominal pain (not due to hunger, constipation, injury, or stress)
  • Nausea, vomiting or diarrhea
  • If you're reporting a COVID related absence, or have questions with what COVID related steps to take after an exposure, please include the information below: 
    • Was your child a close contact to a COVID positive individual (if so, when):
    • Has your child received a positive COVID test (if so, when):
    • When did symptoms (if any) start:

Parent/Guardian Contact Information