Middle School Attendance Form
Please use this form for reporting the absence of your Middle School student. If you need to talk with someone, please indicate this in the last question below for a call back. You can also call the Middle School office directly at (608)592-3854. 
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Email *
1. First and Last Name of Middle School Student who will be absent *
2. Name of the person filling in this form and your relationship to the student.  *
3. Grade of Student
4. Please provide the phone number we can call if we have any questions.
 *
5. Date(s) that your student will be absent. (Month/Date)
 *
6. What is the reason for the absence? *
7. If your student is arriving to school late/leaving early, please let us know what time. 
8. If your child is ill, what are the symptoms?
9. Does your student meet the criteria for a COVID test? If testing is recommended, please include a comment here about the test result if it is known at this time. 

If your student is considered symptomatic for COVID, testing is recommended if they have:
* One of the following symptoms - frequent cough that is not connected to a previous illness in the past 2 weeks, difficulty breathing, new loss of taste or smell.
* Or two of the other symptoms above baseline -
fatigue, headache, muscle or body aches, sore throat, congestion or runny nose, nausea or vomiting, fever or chills, diarrhea.



10. If your child is ill, do you have any confirmed diagnosis from a doctor? Please list diagnosis (Strep Throat, Influenza A, RSV, COVID, ear infection, etc.)
11. Anything else you want us to know?
12. Do you want someone from the office to give you a phone call to follow up? (Please be sure to include a contact number in question #4 above) *
A copy of your responses will be emailed to the address you provided.
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