Confidentiality Statement: This form is being used to facilitate the safety of you or another student and to provide a confidential avenue to report your concerns. The information you provide will be kept in the strictest confidence. However, we are bound by law to share with law enforcement officials any information that indicates that you or another person have committed or are about to commit an act which may be harmful to yourself or others. False reporting of an incident is against state law and school policy. Section 240.50 of the New York State Penal Law states: A person is guilty of falsely reporting an incident where knowing the information reported, conveyed or circulated to be false or baseless, he/she initiates a false report warning or an alleged occurrence or impending occurrence of a crime, catastrophe or emergency under circumstances in which it is not likely that public alarm or inconvenience will result. This is a Class A Misdemeanor. I understand the above.