HCISD Bullying Report Form
As defined in the HCISD Student Handbook....

Bullying occurs when a student or group of students engages in written or verbal expression, expression through electronic methods, or physical conduct against another student on school property, at a school-sponsored or -related activity, or in a district operated vehicle, and the behavior:

Results in harm to the student or the student’s property;

Places a student in reasonable fear of physical harm or of damage to the student’s property; or

Is so severe, persistent, and pervasive that it creates an intimidating, threatening, or abusive educational environment.

This conduct is considered bullying if it exploits an imbalance of power between the student perpetrator(s) and the student victim and if it interferes with a student’s education or substantially disrupts the operation of the school.

Bullying is prohibited by the district and could include hazing, threats, taunting, teasing, confinement, assault, demands for money, destruction of property, theft of valued possessions, name-calling, rumor-spreading, or ostracism. In some cases, bullying can occur through electronic methods, called “cyberbullying.”

When submitted, this form will be forwarded to the appropriate campus counselor and principal.

I am a *
Alleged Victim's Name *
Your answer
Alleged Victim's Campus *
Alleged Victim's Grade *
Alleged Bully's Name *
Your answer
Alleged Bully's Grade *
In what way does the alleged bully have more power than the alleged victim? *
Date of Incident: *
MM
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DD
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YYYY
Time of Incident: *
Time
:
Is the alleged bullying that you are reporting done: *
Submit
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