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Absentee Reporting for Noble Leadership Academy
Please report your child's absence on this form. If your child is missing school for a doctor's visit, please make sure to submit a copy of the excuse form from the doctor's office either to the main office or emailed to
nurse@noblela.org
.
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Date
MM
/
DD
/
YYYY
Name of Student
Your answer
Grade of Student
Prek
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
Sixth Grade
Seventh Grade
Eighth Grade
Ninth Grade
Tenth Grade
Eleventh Grade
Twelfth Grade
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Is your child sick?
Yes
No
Clear selection
Is your child missing school for a doctor's visit?
Yes
No
Clear selection
Is your child missing school for a non-medical reason?
Yes
No
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If your child is sick, please check off the symptoms he/she is experiencing?
Fever of 100.3F or higher
Vomitting
Gastrointestinal Issues (Stomach ache or Diarrhea)
Respiratory Issues
Sore Throat
Shortness of Breath or Difficulty Breathing
Muscle Pain or Body Aches
Headache
Other:
If your child is sick, have they been diagnosed with any of the following:
Strep Throat
Head Lice
Rash
Conjunctivitus (Pinkeye)
Other:
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