Safety Report Form

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Safety Report Form

Please use this form to report any safety hazards, virtual safety concerns (i.e. internet filters), or person-to-person interactions you see . All immediate safety concerns will be reviewed as soon as possible, non-immediate concerns will be reviewed at the next Safety Committee meeting. Thank you for keeping our school safe for staff and students!

Name *

Are you a: *

Student

Parent/Guardian

Staff member

Location *

For a timely response, is this concern: *

Immediate - Needs action NOW!

Not immediate - Can wait until next committee meeting

Type of concern: *

Safety Hazard

Virtual Safety Concern

Person-to-Person Concern

Other:

Brief Explanation of Concern and exact location *

Submit

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