Absence Excuse Form

Absence Excuse

After 3 days, a doctor's note is required in order to excuse sick days. After 10 absences, all absences need a doctor's note if labeled sick. Please send notes to student's teacher when they return. Thank you!

Name of Student
First Last
Room #/ Grade
Please choose your child's room number/ teacher/ grade.
Date of Absence * Required
Please click on the date your child was absent. If only absent one day, you do not need to fill out the same date on the following Date of Absence places. Only for multiple dates.
MM slash DD slash YYYY
Date of Additional Absence (if needed)
Please click on the an additional date if needed. (only if needed)
MM slash DD slash YYYY
Date of Additional Absence (if needed)
Please click on the an additional date if needed.
MM slash DD slash YYYY
Date of Additional Absence (if needed)
Please click on the an additional date if needed.
MM slash DD slash YYYY
Date of Additional Absence (if needed)
Please click on the an additional date if needed.
MM slash DD slash YYYY
Date of Additional Absence (if needed)
Please click on the an additional date if needed.
MM slash DD slash YYYY
Reason for Absence * Required
Please check the reason your child was absent from school.
- Illness/ sick
- Family Emergency
- Death in the Family
- Out of town
- Approved Religious Holiday
- Required Court Appearance
- Doctor/Dentist Appt.
Comments for Teacher/ Admin
Parent/Guardian Name * Required
First and Last name of legal guardian.
First Last
Consent * Required
I certify that I am the legal parent/guardian of above named student.
Phone
Email
Please complete email to receive confirmation!
Enter Email Confirm Email
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Stephen Girard Elementary School

Please fill out the following information about your student's absence. You do NOT need to send in a written note if you fill this form, however, Doctor's notes must be handed into the school. Thank you!

Absence Excuse Form

Absence Excuse