RHS - Bullying / Harassment Report
Name
Entering your name is optional.
Your answer
What is your current grade level? *
If a parent, guardian and/or community member, please use other and enter your information.
When did the incident occur? *
If you do not know the exact time and date, please estimate.
MM
/
DD
/
YYYY
Time
:
Did the incident occur over a online social media outlet? *
Please mark all that apply.
If you answered NO to the question above, where did the incident take place.
Please mark one of the selections.
Name of Victim *
Person who is being victimized or bullied. This is a required question to submit the form. If you don't know their name, please enter initials, first name, last name, or even a class you have them in.
Your answer
Name of Suspect
Person who is bullying or causing the incident. If you do not know the name, please leave blank or enter a description of the person.
Your answer
Please provide a description of what happened. *
Provide as much detail as possible
Your answer
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