Lausd Illness Form - New absence extension of ongoing absence intermittent absence/reduced schedule. Certification/request of absence for illness, family illness, new child. (last modified on february 16, 2024) Student needs special consideration because: Web los angeles unified school district. Select the appropriate type of absence: Please review this form and initial the appropriate column below. Employee information (please print) reason for absence. Typically, these types of absence do not qualify for the family and medical leave act (“fmla”) and/or the. Web total time (expected) of absence:
(last modified on february 16, 2024) Web los angeles unified school district. Employee information (please print) reason for absence. _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ lausd district nursing services original form. This form does not supersede or replace the leave of absence request form (pc form 5006), or (hr form 1065), when required. Certification/request of absence for illness, family illness, new child. 6307.5 certification of absence fo. Please review this form and initial the appropriate column below. Starting date of absence / / last date of absence (expected) / / _ New absence extension of ongoing absence intermittent absence/reduced schedule. Web total time (expected) of absence: Typically, these types of absence do not qualify for the family and medical leave act (“fmla”) and/or the. Web confidential health information to school personnel: Select the appropriate type of absence: Student needs special consideration because: