REPORTING ABSENCES 2020-2021

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THIS FORM IS JUST TO BE USED TO REPORT AN ABSENCE. LATE ARRIVALS, EARLY DISMISSALS PLEASE CALL THE MAIN OFFICE.

Please refer to the SPC decision tree for questions related to how Covid-19 Symptoms must be handled until further notice. We will do our best to update symptoms and protocols as new information becomes available.

Thank you for all you are doing to keep the community of SPC safe and health!

NEW AS OF 11/9-- If you are reporting a confirmed case of COVID-19 exposure please complete the COVID-19 EXPOSURE/POSITIVE TEST RESULT FORM

Email *

DATE *

YYYY

CHILD'S FULL NAME *

CHILD'S GRADE *

Preschool

PREK

Kindergarten

1st Grade

2nd Grade

3rd Grade

4th Grade

5th Grade

6th Grade

7th Grade

8th GRade

CHILD'S HOMEROOM TEACHER

Mrs Spanos (PRESCHOOL)

Mrs Archer (PRESCHOOL)

Mrs Dietz (PRESCHOOL

Mrs. Connolly (PREK)

Mrs. Xamplas (PREK)

Mrs. Burke (PREK)

Mrs Kusinski (Mrs. O'Connor) PREK

Mrs. Hader- 1st Grade

Mrs. Kraft 1st Grade

Mrs. Dohr 1st Grade

Mrs. Galvin 2nd Grade

Mrs. McCallister 2nd Grade

Mrs. Chaparro 2nd Grade

Ms Chambers 3rd Grade

Mrs Johnson 3rd Grade

Mr. Cerjak 4th

Mrs Lewandowski 4th

Mrs Zimmerman 4th

Mrs Valdez 5th

Mrs Huber 5th

Mrs. Meo 6th

Mrs Pecoraro 6th

Ms. Hayes 6th

Mrs Ufheil 7th

Mrs Stypka 7th

Mr Okimoto 7th

Mrs Shultz 8th

Mrs Donahue 8th

Ms Guarnieri 8th

Other:

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PARENT NAME (person completing form)

REASON FOR ABSENCE (if not if not sickness) If traveling please list where you are going.

I am reporting my child(ten) sick because a family member in the home is sick with Covid Symptoms..

Yes

Other:

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My child is exhibiting the following symptoms: *

Fever (100.4 or higher)

Headache

Shortness of breath

Cough

Sore Throat

Vomiting

Diarrhea/abdominal pain

Congestion/runny nose

New Loss of taste/smell

Nausea

Fatigue or muscle body ache.

My child is not exhibiting any of the above symptoms.

Other:

Required

I know I have to keep all students who attend SPC in the household home if I have a child who is exhibiting symptoms. All my children attending SPC will be kept home per the guidelines. (please refer to the SPC Decision Tree located on the SPC WEBPAGE) *

YES

I know I have to submit a Dr.'s note prior to my child and (all SPC students in my household) prior returning to school for any reason related to any illness. I will ask the Dr to provide an alternative diagnosis per the infection protocol. I will email the note to Mrs. Fletcher (preschool-2) or Mrs. Foy (3-8)(please refer to the SPC Decision Tree located on the SPC WEBPAGE) *

YES

Do you have any additional comments related to this submission?

A copy of your responses will be emailed to the address you provided.

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