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Face Covering Exemption Forms
Student Face Covering Exemption Form-English | Spanish  Hmong

Visitor Face Covering Exemption Form-English
  | Hmong

All staff, students and visitors will be required to wear a face covering when in District facilities, and transported in District vans/school buses. Under the Governor’s emergency order for individuals to wear face coverings and the City of Green Bay Common Council’s face covering resolution, there were limited exemptions from wearing a face covering, which include:
  • Individuals who have trouble breathing
  • Individuals who are unconscious, incapacitated, or otherwise unable to remove the face covering without assistance. 
  • Any individual who falls within the Centers for Disease Control's guidance for those who should not wear face coverings due to a medical condition, mental health condition, or disability that prevents them from wearing a face covering. 
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  

Some additional considerations with respect to face coverings include:
  • The District will provide staff and students two (2) washable face coverings. 
  • If a student chooses to wear their own face covering, 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.
  • The District is working to address the needs of our Deaf and Hard of Hearing staff and students. 
  • Phy-ed classes will be held with face coverings being worn for indoor and outdoor classes. 
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