Absence Report Form

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Absence Report Form

Please call the attendance line if you have any issues with this form - 408 335 2145

Student's name *

Teacher name *

Student grade *

Date(s) of absence *

Reason for absence *

Fever (99.6 degrees F or greater)

Chills, Muscle or body aches

Fatigue

Shortness of breath/difficulty breathing

Loss of taste or smell

Cough/Sore throat

Headache

Nausea, Vomiting or Diarrhea

Running nose/congestion

Stomach ache

COVID-19 exposure or positive test

Other contagious illness requiring follow up

Appointment

Vacation/Trip

Other

Your name *

Your relationship to the student *

Email address

Submit

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