Influenza Sentinel School Surveillance 2014-15

1. Please provide the following information:
2. County:
3. Reporting MMWR week ending schedule:
(Choose the week you are reporting for based on the last day of that reporting week. Each reporting week is defined Sunday though Saturday. The date listed below is the last day for the reporting week. For example, if you are reporting for the week of September 7- September 13, 2014, choose September 13, 2014)
Reporting week
4. Total number of students absent due to illness (including non-influenza illnesses) for the reporting week
5. Total of student enrollment for the reporting week - please enter the total in the last row of your weekly log sheet.
(Note that the total is the sum of each school day student enrollment for the week. For example, if 200 students are enrolled on Monday, 199 on Tuesday, 199 on Wednesday, 199 on Thursday, and 199 on Friday, the total of student enrollment for the week will be 996 – the sum of the numbers from Monday through Friday. If school was closed on Monday, then Monday count will not be included and the total enrollment for the week will be 796 – the sum of the numbers from Tuesday through Friday)
6. Comments: