Face Covering Exemption Forms

Student Face Covering Exemption Form-English | Spanish | HmongSomali

Visitor Face Covering Exemption Form-English
 | Spanish | Hmong

Parents/guardians or individuals wishing to request an exception, will need to submit the Face Covering Exemption Form, which needs to be completed by the student's/individual's health care provider prior to entering a District facility (school) or riding District (van/school bus) transportation. The completed form should be submitted to the District’s Lead Nurse, Kristen Johnson at [email protected].  

Some additional considerations with respect to face coverings include:
  • Face coverings must follow the District’s dress code policy, Policy 443.1 - Student Dress (to view the policy, please visit BoardDocs and search for the policy).
  • Face covering means a manufactured or homemade cloth covering that fully covers an individual's nose and mouth and that is secured with ear straps or otherwise tied so as to prevent slipping, and/or a face shield which covers the mouth and nose, covers the side of the face, and is secured on the head.
  • Face shields may be worn with a face covering that covers the mouth and nose. 
  • A cloth face covering can be made of synthetic or natural fabrics.
  • The covering should fit snugly against the face without gaps.
  • The face covering should be secure and not slip once it is on.
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