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Medical Exemption From Mask Request
Please complete this form if you will request a medical exemption from wearing a mask. A doctor's note supporting your request must be received by the building nurse (via mail or fax) by September 8th.
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Student's Last Name
*
Your answer
Student's First Name
*
Your answer
Student's School
*
West
Lindell
East
Lido
Middle School
High School
Student's Grade Level in September
*
Pre-K
K
1
2
3
4
5
6
7
8
9
10
11
12
Ungraded
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