OLCHS Bullying Report Form
Use this form to report an incident of harassment, bullying, or cyber-bullying. You have the option to make the report anonymously. If you need immediate assistance, please contact your dean or guidance counselor.
I am a
Guardian/Family Member of OLCHS Student
Type of Incident
How did you become aware of the incident?
I am the one being bullied
I witnessed the incident
I heard about the incident from another student
I heard about the incident on social media
Did you report the incident to a staff member? If yes, Who?
Please describe what happened
The more detail you provide the better
Alleged Bully -List more than one if necessary
If you are the alleged victim and wish to remain anonymous, just enter the word "Me" in the box below.
Please list others that observed the incident or could provide more details.
Date and Time of the Incident
Location of the Incident
What type of help would you like with this issue?
Please provide additional details or information to assist the school staff
(if you are being cyberbullied, please save screenshots from the incident)
Optional, but helpful
Optional, Email Address or Phone Number
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service