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Sandusky County School Absentee Surveillance
Please complete and submit this form weekly during flu season
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* Indicates required question
The influenza reporting period is 12:00AM
Sunday
through 11:59PM
Saturday
. Please complete this survey no later than Monday by the end of the business day.
The school district I am reporting for is:
*
Bishop Hoffman Catholic Schools
Clyde-Green Springs
Fremont City School District
Gibsonburg Schools
Lakota Local School District
School of Hope
Solomon Lutheran School
Vanguard
Woodmore Local Schools
Other:
Report Week
Start Date
(Sunday):
MM
/
DD
/
YYYY
Report Week
End Date
(Saturday):
MM
/
DD
/
YYYY
Total Student Population:
Your answer
Number of Days in Session:
Your answer
Total Number of Students
Absent Related to Illness
:
Your answer
Additional Notes/Information that might be relevant to this reporting week:
Your answer
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