SRV Community Health and Safety

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Maintaining a safe, friendly, and educational climate at San Ramon Valley High School is the top priority of the entire staff and administration team. Do you have questions or concerns that you would like to share about student health and safety, facilities, and/or campus climate? Let us know through this 100% ANONYMOUS form so that they can be addressed.
Please provide a thorough description of the issue and answer the questions that relate the most to your concern.

There are 3 categories:

1) Student health/safety
2) Campus facilities
3) Campus climate

1) Are you concerned about the health and/or safety of yourself or another student?

Please provide as much information as possible including names. (ex: bullying, depression, suicidal thoughts, anxiety, drug abuse, etc.) For example: " I was on campus Thursday afternoon after cross-country practice when I saw a student being harassed by what seemed like another student in F hall, outside F3. The student being harassed seemed hurt, but I was afraid to help at the time. It was around 5:15pm and both students appeared to be sophomores. The bully was a tall and blonde boy, while the boy being bullied was short and had dark hair."

1a) What do you believe can be done to resolve the issue/concern you talked about in question #1?

1b) How serious issue/concern you talked about in question #1?

Not serious, the student is not at risk

Very serious, the student is at risk/unsafe

Clear selection

1c) How immediate is the issue/concern you talked about in question #1?

If a timeframe is known, PLEASE provide it in your response to question #1. If you believe someone is an immediate danger, PLEASE contact an adult ASAP or call 911.

Not very immediate

Requires immediate attention

Clear selection

2) Do you have an issue regarding campus facilities or the abuse of campus facilities?

Please provide as much information as possible. (ex: leaking sink, broken bench, vaping in the bathroom, vandalism, etc.) For example : "The sink in the boy's E hall bathroom is leaking. We're in a drought and it should be fixed as soon as possible so that it doesn't waste water."

2a) What do you believe can be done to resolve the issue/concern you talked about in question #2?

2b) Is your answer to question #2 a significant safety issue?

Not really

It is dangerous and needs immediate attention

Clear selection

3) In there an issue inside or outside of the classroom that you believe effects the campus climate in a negative way?

Please provide as much information as possible. (ex: unsafe classroom environment, disrespectful students/staff, classroom/homework stress, prejudice against a group of students, etc.) For example: " I don't feel as if my opinion is being respected by other students in my 5th period class, staff have not been able to help because they haven't been able to observe what's happening. I've stopped sharing ideas in fear of being rejected and no longer feel comfortable in the classroom."

3a) What do you believe can be done to resolve the issue/concern you talked about in question #3?

4) Your contact information *optional*

Please provide this if you'd like us to reach out to you for more information or want follow-up.

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of SRVUSD.net.

Does this form look suspicious? Report

Forms