HomeMy WebLinkAboutOCDSB 967 Referral to Attendance CounsellorReferral to Attendance Counsellor
Please complete this form for compulsory aged students only 6-17yrs with prolonged absence.
Prolonged Absence is defined as the absence of a pupil for 15 consecutive school days without
appropriate supporting documentation.
For prolonged absences a referral MUST be made to the attendance counsellor (OCDSB
school social worker) between the 11th and 16th consecutive day of absence for the
student to remain on the roll.
OEN: ___________________
Grade: __________________
Student Name: _____________________________
School: ___________________________________
Date of Referral (Day 11-16):
Referring Principal/Designate: _____________________
Attached: Daily Attendance Record Short Index Card
Copy of First Attendance Letter to Parent(s)/Guardian(s) (if sent)
For School Use:
Referral made (C code entered) Referral accepted in writing
16-30 days: 2-way contact confirmed (C code entered)
Date of contact: _____________ Type of contact:
31-45 days: 2-way contact confirmed (C code entered)
Date of contact: _____________ Type of contact: _____________________
46-60 days: 2-way contact confirmed (C code entered)
Date of contact: _____________ Type of contact: ______________________
Reason for Closing Referral (check one if applicable):
Student returned to school Date: ___________________________
Student removed from register Date: ___________________________
Supporting medical documentation received Date: ___________________________
Signature of Principal: ______________________________
OCDSB 967 (September 2019) Original to be filed in OSR
Copy to Social Worker
First day of absence:
*For 6-13 year olds, written evidence must be provided every 15 days for the file to remain active.
/!-- This code was added to remove the metadata from document view in Weblink -->