DCMS Incident Reporting Form 2025-2026
**Reporting form**
Email *
What is your LAST name? *
What is your FIRST name? *
What grade are you in? *
Who was involved in this incident? Please provide first AND last name(s). *
WHERE did the incident occur? *
WHEN did the incident occur? Please provide a date AND a time. *
Explain what happened: *
If there were other people who witnessed the incident, please provide first AND last names. If there were no witnesses please type N/A or none.   *
Have you informed any other adult about the incident? If so, please provide first AND last name. If you did not share information with  any other adult, type N/A or none. *
Is there any other addition information that would be helpful to resolve the issue? If yes, please share. If not, type N/A or non. *
Definition of bullying:                                              
Overt, unwanted, repeated acts or gestures including verbal or written communications or images transmitted in any manner, physical acts, aggression, or any other behaviors that are committed by a student or group of students against another student with the intent to harass, ridicule, humiliate, intimidate, or harm the other targeted student and create a hostile school environment for that student.
Bullying is REPEATED, INTENTIONAL, and involves a real or perceived IMBALANCE of power.
Check all that apply:
 *
Required
Does this incident meet ALL 3 parts of the definition of bullying? *
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