🚻 ¿El baño, por favor? - Regular Restroom/Hall Request

I understand that I can't be out of the room the first or last ten minutes of class, and students will go to the restroom in the order the requests are submitted.


         

       

Name: 


A red asterisk (*) indicates required questions.

  1. I entered my first and last name in the above field.
    Yes
    No


  1. I understand that I will turn in my phone before I leave class and pick it back up after I return.*
    Yes
    No


  1. I understand that if I need to go to a teacher's class or to another staff member, Mrs. Bourne must receive email confirmation from that staff member or teacher first.*
    Yes
    No


  1. I would like to request a pass to the hall for five minutes or less to use the restroom or for some other quick emergency.*
    Yes
    No


  1. I would like to request a pass to the hall for something that is expected to take longer than five minutes.*
    Yes
    No


  1. If you expect to be gone more than five minutes, where are you going?


  1. I understand I need to fill out a nurse's form or counseling form on Clever in order to be called to either the nurse's office or the counseling office.
    Yes
    No


  1. I understand that if I am having an emergency, I can discuss it with Mrs. Bourne.
    Yes
    No





Andrea Bourne