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Daily Student Absence Notification
Student Name
*
First
Last
Parent/Guardian Name
*
First
Last
Parent/Guardian Phone Number
*
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Parent/Guardian Email
*
Reason For Absence
*
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Please report the following
diagnosed
communicable disease:
Strep Throat
Mono
Pink eye
Chicken Pox
Head Lice
Impetigo
Pertussis
Shingles
Scarlet Fever
Scabies
Ringworm
Pin worms
Fifth’s disease
Hand, foot, and mouth disease