San Ramon Valley

This form is used if your student has a chronic illness that will result in multiple absences due to appointments or illness. 

 

To access a chronic illness form (CIF):

1.) Parent/Guardian requests a chronic illness form consultation.  Requests can be made through the attendance office or school nurse.

2.) The school nurse will communicate with the family to decide if a CIF is needed

3.) If so, the school nurse works with the family to get the CIF completed and submitted. 

 

Submit this form to the attendance office and school nurse at your school site.  Please note - you must continue to call the attendance office to report a partial or full day absence even with this form on file.  If the absence is do the chronic illness indicated on the form, inform attendance staff that your student has a chronic illness form on file. 

 

If your student has FOOD ALLEGRIES or DIET RESTRICTIONS and will be purchasing meals from the school cafeteria, please have your medical provider complete this form.  The information provided on this form will allow the child nutrition staff to double check your students tray upon check-out to ensure no allergens or restricted foods have been chosen.