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DOCTOR’S NOTE TO RETURN TO SCHOOL
Date:________________________
Dear Health Care Provider,
_________________________was sent home from our school on___/___/___with symptoms that could potentially be contagious.
In the best interest of keeping our students and staff healthy we ask that the child does not return to school until he/she has been symptom
free for 24 hours (without fever reducers) or with a doctors consent.
This child was sent home with the following symptoms:
Fever of ° taken:
under the tongue with TurboTemp Commercial Thermometer™
under the arm without 1° added with NexTemp™ Clinical Thermometer
pointed at forehead with VeraTemp+™ Professional Non-Contact Thermometer
Red or running eyes, colored discharge from the eyes or nose.
Cough that is persistent or productive.
Sores or crusts on the scalp face or body, including those that are draining.
Skin eruptions or rash.
Sore throat.
Swelling and tenderness of the glands, particularly about the face or neck.
Nausea and vomiting.
Pain and stiffness of neck and/or headache.
Jaundice (yellowing of eyes and/or skin)
Persistent abdominal pain.
Diarrhea.
Other:
Thank you,
Your Friends at Paradigm Care & Enrichment Center
_______________________________________
Physicians Signature
Physician’s office stamp
(REQUIRED TO RETURN TO SCHOOL)
To be filled out by
Doctor:
Date the above named child was seen by Doctor for the above symptoms
Diagnosis for the above named child (we are required by Michigan State Day Care Licensing to
confidentially post this to parents of all students in our program)
Date the above named child is no longer contagious and can return to
school/daycare
Special Instructions: