Report Bullying or Unsafe Behavior
Use this form to report bullying, sexting, substance use/abuse, or any unsafe or unhealthy behavior.
Reporter's / Victim Name
Your answer
Reporter's / Victim Grade *
Bully's Name *
Your answer
Bully Grade(s) *
Bully Gender(s) *
Date(s) and time(s) of Incident
Your answer
Your answer
Give your report. Be as detailed as possible. If this report involves social media, keep / save any evidence for the counselor or principal. *
Your answer
Who should handle your report? *
If you are a parent who is supporting a student and would like a follow up call, please leave your name and phone number.
Your answer
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This form was created inside of Shawnee Heights USD #450. Report Abuse - Terms of Service