Javascript is not enabled. Please enable Javascript in your browser and refresh the page before making a submission.
Name*
COVID-19 Reporting Only
Absence Only
Covid Reporting AND Absence
Possible COVID-19 Exposure/Positive Testing:
If you believe you or anyone in your household has possibly been exposed to COVID-19, or if someone in your household has tested positive, reporting this is required here. Please report in the BOX ABOVE: 1. WHO in the household was possibly exposed or tested positive, 2. DATE of possible exposure or positive test, and 3. HOW possibly exposed. The Nurse will contact you for further info. and with next steps.
STAFF ABSENCE REPORTING:
Date(s) For Absence Request, include month, date, year*
Today's Date* January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2023 2022 2021 2020 2019 2018
Period of Time* Full Day AM PM Other time period, state in Comments below
Type of Absence* Sick/Medical Personal Professional Vacation (12 mo. staff only) Field Trip Funeral for immediate family Jury Duty Other (write in Comments)
Duties That Need to be Covered (Carline, Bus, Lunch, D-Hall, Detention, Before Care, After Care...)
Lesson Plans Will be Left Where
Additional Info/Comments/Reason for Personal Day Absence