Anonymous Reporting Form

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If you or another student are experiencing a problem at Avery ISD, leave your concern below for the administration. You do not need to leave your name. PLEASE--BE AS SPECIFIC AS POSSIBLE. Leaving times, dates, locations, and other information is crucial to resolving your concern. Again, you do not need to leave your name unless you want an administrator to follow up with you. All messages will be taken seriously and will be worked on promptly. If you are experiencing a serious problem that needs immediate attention, you are urged to tell a teacher, school counselor, principal, or other trusted adult as soon as possible.

Name - NOT REQUIRED

Email - NOT REQUIRED

What do you need to report? *

Abuse (Verbal, Sexual, Physical, Mental)

Anger Issue / Loss of Self-Control

Bullying / Cyberbullying

Cutting / Self-Harm

Dating Violence

Depression / Anxiety

Domestic Violence / Child Abuse

Drug or Alcohol Use / Abuse

Eating Disorder

Hate Crime / Hate Speech / Discrimination

Inappropriate Behavior / Language / Gesture

Inappropriate Photos / Videos / Other Graphic

Planned Attack / Fight / Assault

Suicide / Suicide Ideation

Vaping Use / Possession / Distribution

Weapon(s) / Explosive Device

Required

Tell us what is going on. The more you provide, the better we can help. (REQUIRED) *

Who is in need of help? (ONE OF MORE PEOPLE; FIRST NAME, LAST NAME; GENDER, RACE/ETHNICITY, GRADE LEVEL). (REQUIRED) *

When did or will the incident take place (DATE & TIME). (REQUIRED) *

Where did or will the incident take place? (PHYSICAL LOCATION, SOCIAL MEDIA PLATFORM, SCHOOL EVENT). (REQUIRED) *

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