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 *
Type of Incident *
How did you become aware of the incident? *
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 *
Alleged Victim(s) *
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)
Your Name
Optional, but helpful
Contact Information
Optional, Email Address or Phone Number
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