PMS Report an Absence

Please complete all of the information below. If Student Services has any questions, a staff member will contact the student's parent/guardian for clarification.

All absences are considered unexcused until an excuse note is submitted via this form. Students must submit an excuse note within 3 days of last absence.

Absences will be marked excused ONLY for reasons listed in the Pasco County Schools Code of Conduct. All other absences will be marked unexcused.

Thank you.

Students should review the Student Self Screener on our website daily.

Name Name First Last
Student Number
Grade Level

Grade Level 6th Grade 7th Grade 8th Grade
Parent / Guardian Name Parent / Guardian Name First Last
Parent / Guardian Contact Phone Number Parent / Guardian Contact Phone Number - ### - ### ####
Parent / Guardian Email
Date(s) of Absence
Period(s) Missed

Period(s) Missed First Block (7:10 to 8:02) Second Block (8:06 to 8:58) Third Block (9:02 to 9:54) Fourth Block (9:58 to 11:36, includes lunch) Fifth Block (11:40 to 12:32) Sixth Block (12:36 to 1:30)
Total days reporting absent for this entry:
Reason for absence(s): *

Reason for absence(s): * Illness of Student Major illness in the immediate family Religious holiday Religious instruction, conference, institutes, etc. Court order/subpoena Other (please explain below)
Please note that fraudulently filling out this form will result in unexcused absence and possible discipline.

Please note that fraudulently filling out this form will result in unexcused absence and possible discipline. I confirm I am the parent/guardian filling out this form.
Please Upload Dr.'s Notes Here

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Additional Information
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