Brentwood Student Safety Report Form
At Brentwood Middle School, we pride ourselves in our welcoming school environment. As a staff, we are responsible for ensuring the emotional and physical safety for each of our students every day. Please use this form to report any activity that either makes you as a student or another student feel unsafe so our administrative team can address it. As a student, you know what is happening in our building, and we appreciate you taking the time to make Brentwood the safest place to be!
Event Description *
Describe the event in detail including what happened, who was involved, where it happened, when it happened, and how you know about it.
Your answer
Event Type *
What time and date did the event occur? *
MM
/
DD
/
YYYY
Time
:
Where did the event take place? *
If the victim or suspect used social media, please select they type of social media below.
Who were the individuals involved in the incident?
Name *
Your answer
Grade
Your answer
Name of school student attends IF other than Brentwood
Your answer
Name
Your answer
Grade
Your answer
Name of school student attends IF other than Brentwood
Your answer
Additional individuals involved
Your answer
Reporter's Information
You are able to remain anonymous, but providing your information may help us to better address the situation.
Your name (optional)
Your answer
Connection to BMS
May we contact you?
Please provide your contact information if you are not a student.
Phone number and/or email address
Your answer
Submit
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