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
Submit
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