UW-Baraboo/Sauk Illness Report
Answers marked with a * are required.
1.
UW-Baraboo/Sauk County Report
1.
You are reporting a sick day(s) for the week of
NOTE:YOU CAN ONLY REPORT ONE WEEK AT A TIME *
Jan 4-8
Jan 11-15
Jan 18-22
Jan 25-29
Feb 1-5
Feb 8-12
Feb 15-19
Feb 22-26
Mar 1-5
Mar 8-12
Mar 15-19
Mar 22-26
Mar 29- April 2
Apr 5-9
Apr 12-16
Apr 19-23
Apr 26- 30
May 3- 7
May 10-14
2.
Enter number of days absent for the week you chose
*
1
2
3
4
5
3.
You are
*
Student
Facutly
Staff
4.
Report reason
*
H1N1 Confirmed
Flu like symptoms
Caring for others
other
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