Incident Report - Student Safety Report/Concern

If you or another student at HSLJ are experiencing a problem or would like to report a school-related incident, please fill out the form below.  After submitting your responses, an email will be sent to campus administrators immediately.  You may submit this form anonymously; however, if you would like someone to personally follow up with you, then be sure to leave your information at the bottom of this form.  Reporting anonymously may hinder our ability to fully investigate or assist with resolving your concern.

In terms of your concern, please be as specific as possible. Leaving dates, times, locations, and any other specific information may be critical to resolving your issue in a quick manner, so please be sure to thoroughly complete those sections.  

All messages will be taken seriously and will be worked on promptly - all disciplinary actions/decisions are based on information collected and guidelines noted in the HISD Student Code of Conduct. That said, if you are experiencing a serious problem that needs immediate attention, you are urged to tell an administrator, teacher, or other trusted adult as soon as possible. You may always message any administrator or teacher on Microsoft Teams.
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What happened? *
When was the last time this occurred? *
Where is the problem occurring?(At school, online, in neighborhood, other) *
Who is directly involved with this problem? *
Are there other people we should talk to about this (witnesses, students who know about it, parents, etc...)? *
What else might be helpful for us to know?
Name - (If you choose to remain anonymous, please know that proper investigations may be difficult to complete if further information is needed)
Email/School Email/Contact Info
Grade Level
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