Mill A Harassment, Intimidation or Bullying (HIB) Report Form
Reporting Form
Sign in to Google to save your progress. Learn more
Reporting person (optional)
Targeted student:   *
Your email address (optional)  
Your phone number (optional)
Today’s date   *
MM
/
DD
/
YYYY
Name of school adult you’ve already contacted (if any)  
Name(s) of aggressor(s) (if known)  
On what dates did the incident(s) happen (if known)  
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Mill A School.

Does this form look suspicious? Report

Google Forms