Incident Reporting Form
Do not use this form if there is an immediate threat to Students, Staff, or Buildings, instead call 911.
Contact Info: phone/e-mail/homeroom (optional)
Your answer
Today's Date: *
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Incident Date: *
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Name of adult(s) you have already contacted (if any) *
Your answer
Name(s) of accused (if known) *
Your answer
Where did the incident happen: *
Please check the item that best describes what the accused did. Please choose all that apply. *
Required
Describe what happened. Use exact language and as much detail as possible. *
Your answer
Is this report being made by a
I agree that this information is accurate and to the best of my knowledge. *
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