Report of COVID-Related Absence & Class Recording(s) Request

Student Name

Your Email

I am requesting that my attendance for the following date(s) be adjusted and that I be marked as present because of the conditions met below. I also request a recording of the class(es) that I missed.

For these above listed dates, I certify that I attended my course via Zoom or that I watched class recordings on the above referenced dates, that this information may be checked, and that misrepresenting my attendance could result in a Disciplinary Code Violation (Initial).

Initial all that apply:

I tested positive for Covid-19

Date of Test

I understand that the isolation period is for 10 days from the day my test was administered. I further understand that I must submit my test results along with this form for this form to be accepted.

I am unvaccinated and had a confirmed close-contact exposure to Covid-19

Date of Exposure

I understand that the isolation period is 10 days from the date of exposure.

I was symptomatic on the date(s) listed above and was tested for COVID-19 within 24 hours of becoming symptomatic

Date of Test

I understand that I must submit my test results along with this form for this form to be accepted.

I am vaccinated but was instructed by Albany Law School to take remote classes because of exposure to COVID-19

Other COVID-relates reasons as set for the below:

Date of exposure

Signature

Sign above

Date