RECHS/RCS Bullying Report
Please let us know about any bullying that may be occurring in our school. We want to make sure our students feel safe. This information is reviewed regularly during school hours. If this is an emergency or needs immediate attention please contact your student's Principal or counselor directly.
Today's Date *
Your answer
Your name (optional)
Your answer
Your telephone number and/or email address (optional)
Your answer
Are you a: *
Name of student being bullied: *
Your answer
Name of alleged offender(s) *
Your answer
Date of the incident *
Your answer
Name of any other person that could have seen the incident and could provide more information
Your answer
Where did the incident occur (check all that apply) *
Required
Check the statement that BEST describes what happened: *
Required
To your knowledge, has this been reported before? *
To your knowledge, has this type of incident happened with this student before? *
Is there any additional information that you would like to provide? *
Your answer
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