SHS Report an Absence
Student's Name
*
First Name
Last Name
Student's ID #
*
Student's Grade Level
*
Please Select
9th Grade
10th Grade
11th Grade
12th Grade
Period of Absence
*
Reason for Absence
*
Please Select
illness
chronic health (form on file)
mental/behavioral health
medical, dental, or vision appointment
bereavement
family emergency
religious holiday
family travel
other
Other: Please explain the reason for the absence below.
*
Illness
Answering the following questions about your child's illness will help to support the health and safety of our SUSD community. We will maintain confidentiality to the greatest extent possible in accordance with medical privacy laws.
Is your child experiencing flu-like or COVID19-like symptoms? (Fever 100.0+ or feeling feverish/chills, Cough, Shortness of breath or difficulty breathing, Sore throat, Runny or stuffy nose, Muscle or body aches, Headaches, Fatigue (tiredness), May have other less common symptoms such as nausea, vomiting, or diarrhea.)
*
Yes
No
Please select the symptoms your child is experiencing.
Fever (Temperature 100.0 or higher)
Cough, Shortness of breath or difficulty breathing, Sore throat, Runny or stuffy nose, Muscle or body aches, Headaches, Fatigue (tiredness)
Vomiting or Diarrhea
Does your child have a suspected/confirmed case of COVID19?
Yes, suspected
Yes, confirmed
No
Other information
Upload medical documentation
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Name of person submitting absence notification
*
First Name
Last Name
Relationship to student
*
Please Select
Custodial Parent
Legal Guardian
Other
Parent's Email Address
*
example@example.com
Daytime Phone Number
*
Please enter a valid phone number.
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