Bystander Reporting Form
Type of Incident
Who is the victim? If more than one victim, include all names.
Who is the perpetrator (person doing wrong)? If more than one person, include all names.
Time and Date of the incident
Please describe the incident (give all details).
Is this an ongoing problem or a one time incident?
Where did the bullying happen?
Have you reported this incident to anyone yet? if so, to whom? (teacher, parent, etc.)
Your name (Optional)
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service