Student Absence Notification

Student Absence Notification

This form should be completed by a student or their parent/carer in the event of absence from College (including Online lessons). Once submitted this form will send a notification to the relevant teaching department.
Are you completing this form as a Student or on their behalf as a Parent/Carer or Staff Member? *

Student Parent/Carer College Staff Member
Your details
Parent/Carer Name *

First Name Last Name
Contact Phone Number *
Staff Member Name *

First Name Last Name
Student details
Student Name *

First Name Last Name
Student ID Number
Which month were you born in? (Student) *
Please select your campus *

Amersham Aylesbury Wycombe
Please select the Aylesbury department you belong to *
Note: Please only select English & Maths, if this is the ONLY subject studied at College.
Please select the Amersham department you belong to *
Note: Please only select English & Maths, if this is the ONLY subject studied at College.
Please select the Wycombe department you belong to *
Note: Please only select English & Maths, if this is the ONLY subject studied at College.
Which course do you study with us? *
When will you be absent (today's date is selected by default) *

Day Month Year
I will be absent for... *

Whole Day Morning Afternoon Just a few minutes (running late)
Why are you absent? *

Feeling unwell (General illness) Feeling unwell (Possible COVID 19) Feeling unwell (Confirmed Positive COVID 19 Test) Self Isolation due to others in household (COVID 19) Self Isolation due to other contacts (COVID 19) Self Isolation after being asked to by NHS Test & Trace (COVID 19) Worried or Anxious Travel Problems Money Problems Technical Problems (Internet/Computer) Problems with others at College Doctors Appointment Driving Test (not Lesson) Bereavement (Family member/Friend has passed away) Rather not say
Why do you think you might have COVID-19? *
Do you have any of the following symptoms? *

Frequent Cough High Temperature Loss of taste or smell No, I don't have any of the above
Has the member of your household had a test for COVID-19? *

Yes No
When was the member of your household tested for COVID-19? *

Day Month Year
When were you contacted by NHS Test and Trace? *

Day Month Year
What date were you given for when your isolation will end? *

Day Month Year
What was the test result? *

Positive (Has/Had COVID 19) Negative (Did not have COVID 19) Waiting on results of test
Where did you come into contact with the person who has COVID19? *

At College At your workplace Social gathering Don't know
You have selected you have had a COVID 19 test which has been returned with a Positive Result (You have COVID-19).

Please complete the rest of this form to give more details so we can support you and those you might have had contact with recently.

Do not attend College and follow the instructions you have been given to isolate at home.

Important : If you have not had a COVID 19 test and think you might have COVID-19 select "Possible COVID-19" option above. If you are just unwell select "General Illness" above.
When did your symptoms first appear? *

Day Month Year
When were you last in the College building? *

Day Month Year
Have you had a test for COVID-19? *

Yes No
What was your test result? *

Positive (Has/Had COVID 19) Negative (Did not have COVID 19) Waiting on results of test
When were you tested? *

Day Month Year
Which areas did you visit? (Tick all you can remember) *

Classrooms / Workshops Refectory Learning Centre Sports Hall / Gym Toilets
Do you travel by public transport (Train, Bus, Minibus) to College? *

Yes No
Which Train, Bus or Minibus do you use? *
Give as much detail as you can, such as the Bus Number or Train time
As you have selected one or more symptoms related to COVID 19 or indicated that you might have COVID-19 we ask you to stay at home.

Our team will contact you after you submit this form with further questions and instructions.
If you would like to explain the absence further, please detail here.
True content
True covid alert
Please submit this form by clicking the button below.
Submission ID *
Unique Sub ID
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Student Absence Notification

Your details

Student details