SAFE (Sharing Anonymously For Everyone) - Online Form
This form can be used to report concerns to the school including but not limited to: concerns for the safety and well-being of others, acts of bias or prejudice by students or faculty, and other incidents (such as harassment) safely and anonymously. Please fill out this information to the best of your ability so we can address the issue. Feel free to use names as necessary.
* Required
**PLEASE NOTE*** This form will only be monitored during school operating hours (M-F 7:15am - 2:45pm) and will not be checked on the weekends or holidays. Please utilize outside emergency resources if there are life threatening or safety concerns.
Person Making Report (if using your name please mark "Other" and write your name in:
*
Student
Parent
Staff
Anonymous
Other:
Person concern is about:
*
Your answer
Additional people involved (including witnesses):
*
Your answer
Date of concerning incident (if known):
MM
/
DD
/
YYYY
Time of concerning incident (if known):
Time
:
AM
PM
Describe with as many details as possible, the incident of concern:
*
Your answer
How did you come to know about this situation?
*
Personally involved
A friend
Over heard conversation
Someone (not a friend) told me
Social Media
Witnessed it happening to someone else
Required
Is there anyone else we should talk to or who has information about this situation? If so write the name in the "Other" choice?
*
Yes
No
Other:
Required
Please rate the urgency level of this situation from 1-5:
*
1 - It can wait but preferred by end of week.
2 - Important but can be addressed tomorrow.
3 - Address by end of day.
4 - Address as soon as possible.
5 - SAFETY ISSUE - IMMEDIATE ATTENTION!!!!!!! **Please consider going to a trusted adult**
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