Chagrin Falls Schools - Student Incident Reporting Form
Please complete the form to report an alleged student incident or violation of the student code of conduct. If you have questions about whether or not you should complete this form, please contact your child's teacher, assistant principal, or principal and request clarification. You may also print and complete a hard copy of this form and submit it directly to the principal's office.
*Administrators will follow-up with you after investigating the reported incident unless anonymity is requested. Due to federal privacy laws, they may only share limited information.
* Required
To which building administrator should this report be forwarded?
*
High School
Middle School
Intermediate School
Gurney Elementary
In what building(s) did the alleged incident occur?
*
High School
Middle School
Intermediate School
Gurney Elementary
Other:
Required
Has your child reported this alleged incident to an adult at school?
*
Yes
No
Unsure
Name of person reporting the alleged incident
Your answer
Your contact information (email or phone number) - add only if you would like follow-up from the investigating administrator
Your answer
I am requesting anonymity - if anonymity is preferred, the investigation may be limited so as not to disclose the source of the complaint and you will not receive follow-up from the investigating administrator
*
Yes
No
Date that this alleged incident occurred.
*
MM
/
DD
/
YYYY
Location of alleged incident.
*
Your answer
Person/People involved with the alleged incident or violation.
*
Your answer
How many times has this alleged incident occurred?
*
This is the first occurrence
This incident has occurred more than one time
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This form was created inside of Chagrin Falls Exempted Village Schools.
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