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OMS Incident/Harassment Form 2025-2026
Form for students, parents and staff to utilize when being harassed or an incident has occurred involving OMS students. There are questions that have been included to help us when reporting to the state.
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Email *
What is your FIRST and LAST name? *
What is your gender? *
What grade are you in? *
What is your role in the school? *
Names of the student(s) involved in the incident. Please include FIRST and LAST names if you know them.  *
Date, time and place of incident *
Did you report this incident to a staff member at school?  And if so, who? *
Describe what happened in as much detail as you can. *
Was this incident related to: *
Name(s) of witness (es) *
Is there documentation or evidence of incident to include?  What is it? *
Any other related information regarding the incident? *
I feel I was harrassed based upon.... *
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