WHS - Confidential Safety Reporting Form
Please use this form to report bullying, harassment, abuse, drug issues, or concerns about the safety of your own life or the life of another person (e.g., suicide, self-injury, etc.) .

The information you provide will be emailed to a school staff member who will check his or her email DURING REGULAR SCHOOL HOURS.

If you or someone you know is in IMMEDIATE DANGER, please
--call 911
--contact a trusted adult or school staff member
--call the Samaritans 24hr Suicide Prevention help line: 508-875-4500.
--call National Sexual Assault Hotline:800-656-4673

NOTE:
This system is completely CONFIDENTIAL and ANONYMOUS. However, providing your name and contact information is very helpful.

* Required Please provide as much detail as possible.
Your answer
My Name: (optional)
We may not be able to help you unless we know who you are.
Your answer
Best way to contact me (optional).
Provide a phone number or email address.
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Wayland Public Schools. Report Abuse - Terms of Service - Additional Terms