Bullying and Incident Reporting Form
Please fill in the following form with as much detail as possible. It can be anonymous but it is best that we have your name so we can help you or get more information. Your privacy will always be respected when making a report.

If you need assistance immediately please see Tim, Kathy, Simon, Carol, Helen or any staff member at school you feel comfortable with.

If you are not at school and still require assistance please utilise the following support services.
https://kidshelpline.com.au/ 1800 55 1800
https://www.youthbeyondblue.com/ 1300 22 4636

When did the incident happen?
Where did the incident happen?
Your answer
Who was involved?
Your answer
What was said or done? - please use the exact words (even if swear words)
Your answer
What is your name?
Your answer
Would you like assistance?
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