Request edit access
OMS Incident/Harassment Form 2026-2027
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.
Sign in to Google to save your progress. Learn more
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).   (People that were present, saw or heard incident.) *
Is there documentation or evidence of incident to include?  What is it? *
Any other related information regarding the incident?  Has this happened before?  Is there any other history related to this incident? *
I feel I was harrassed based upon.... *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of OCS.

Does this form look suspicious? Report

Google Forms