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Bullying and Harassment Report Form

If this is an emergency that needs immediate attention please call 911 or contact your health care provider immediately as this site is only monitored during school hours. Please be advised, if a report is made anonymously it will limit our investigation process and we will be unable to follow up with the person making the report. Students found responsible for deliberately making false reports may be subject to a full range of disciplinary consequences as publicized in student handbooks.

 

Optional: If a report is made anonymously it will limit our investigation process and we will be unable to follow up with the person making the report.
Optional
Are you the target of the behavior?
Are you a:

Information about the Incident

Name of target (of behavior)(Required)
Name of Aggressor (person who engaged in the behavior)(Required)
MM slash DD slash YYYY
Time of Incident(Required)
:

Witnesses

List people who saw the incident or have information about it.

Incident Details

Describe the detail of the incident (including names of people involved, what occurred, and what each person did and said, including specific words used).