Absentee Form

Parent/Guardian Full Name *

Parent/Guardian Contact Number *

Child's Full Name *

Room *

Last day your child attended Madeley Primary School *

First day of absence *

Last day of absence (if more than one day)

Reason for absence *

COVID Positive

COVID Household Contact

Isolating while waiting for COVID test

Unwell

Appointment

Other

If your child is COVID Positive, please select the date of test.

COVID Test type (please leave if not applicable)

If your child is COVID positive, please select the items that apply to your child

Further explanation for absence reason *

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