Anonymous Concerns Reporting Form
Portledge School's Anonymous Concerns Reporting Form is NOT an emergency hotline. If you are reporting an event that could potentially pose an immediate physical threat to any member of the school community, please make immediate contact with the Head of School, or, if the threat is of an emergency nature, call 911.

Portledge School's Anonymous Concerns Reporting Form is NOT intended in any form or fashion to supplement or supplant any mandatory reporting structures that are in place for potential users of this form. Mandated reporters, including teachers, therefore, should not use this form if they suspect that a minor is being abused. Mandated reporters suspecting such abuse are obligated to come forward and call the DSS mandated-reporter hotline, divulging their identity in the process.

This form is intended to facilitate the reporting of sensitive information to school officials, including information regarding discriminatory and/or prejudicial actions and events that stem from identifying characteristics of the victims (race, gender, etc.), bullying, student safety, violence, drug use, and/or students who may be in need of physical and/or emotional care and/or assistance.

Reports submitted here will be forwarded electronically to the Head of School; the Assistant Head of School; the Director of Diversity, Equity, and Inclusion; the Director of Student Life; the Assistant Director of Student Life; and the relevant Division Director(s). At the school administration’s discretion, reports submitted here will also be forwarded to local enforcement agencies.

Portledge highly respects and cares for your privacy. Any personal information collected and used in this process is provided at your sole discretion. No personal information is required for submission.

Any adult in the community who is approached by a community member with information concerning this kind of incident should support the community member in filling out this form, even going so far as to do so alongside the community member.

In filling out the form alongside the community member, the supporting adult should include pertinent information concerning any actions they may have already taken in attempting to address the issue, as this will help inform the investigatory procedures that will be followed.

Adults in the community should feel free to identify themselves in supporting the individual in filling out the form, but these supportive adults are also free to exercise their right to anonymity in not identifying themselves, if that is their choice.

Investigation into all reported concerns will begin within 24 hours of receipt of a report whenever possible and feasible.

Please use the Anonymous Concerns Report program responsibly. False reports submitted through this system undercut the fabric of the Mission and Pillars of Portledge School.
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General Instructions
To the best of your ability, please describe the incident that you are concerned about in as much detail as possible below. The information provided here can contribute to effective follow-up on the part of the School. Please also note that if an incident took place online, more detail as to specific websites and online settings can also be helpful in this respect.
Specific Location of Incident *
Date of Incident *
MM
/
DD
/
YYYY
Time of the Incident *
Time
:
If the date and time you indicated above are approximate or events took place over many days and times, please indicate in the text below any additional information regarding date and time windows or extents.
List of People Involved in the Incident(s) *
Detailed Description of Incident(s) *
If you are willing to be contacted regarding the incident(s) you are reporting, please provide your name, your relationship to the community (current student, parent/guardian of current student, current faculty member, etc.), your email address, and a phone number at which we might be able to reach you during school hours. Please note that this is NOT required information.
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