I have no reason to believe that my child has an infectious disease and I have followed all medical and public health guidance with repect to exclusion of my child from educational facilities.
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Child's Name (required)

Child's Class (required)
—Please choose an option—Junior InfantsSenior Infants1st Class2nd Class3rd Class4th Class5th Class6th Class

Number of days absent (required)
—Please choose an option—1234567891011121314151617181920

Please tell the start and finishing dates of your child's absence, inclusive. (required)

Dates Absent, Start Date (required)

Dates Absent, End Date (required)

Please tell us the reason for your child's absence (required). If 'Other' please fill in the details below.
IllnessAppointmentHolidayBereavementOther

Other reason for absence.

Signed (required)

Telephone (required)

Email (required)

Please tell us your relationship to the child. (required)

Please indicate whether you are sending in illness cert or other documentation relevant to your child's absence. (required)
—Please choose an option—YesNo

If you wish to provide us with a copy of an illness cert or any other form of documentation related to your child's absence you may do so using the field below.