HISD Anonymous Bullying Report Form
If you have information regarding bullying and would like to report this information, please complete the following form to the best of your knowledge. Please note that this form is completely anonymous.

NOTE: Making FALSE reports will be taken seriously to the full extent of the law.

Today's Date
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Name of Alleged Victim(s) [Person(s) Being Bullied]
Your answer
Name of Alleged Bully [Person(s) Accused of Bullying]
Your answer
Where did the incident occur? (Be specific)
Your answer
Date the incident occurred
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Time
:
Describe in detail what happened.
Your answer
List any persons who witnessed the alleged bullying. (Include your name IF you would like to be contacted.)
Your answer
Provide additional information you feel is important.
Your answer
Submit
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