Bully Report Form
Use this form to report an incident. You DO NOT have to give your name. All reports are kept confidential. This report will go to administration and the counselor.
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Name: (Optional)
Date and time of incident you are reporting: *
Place this incident occurred; (school grounds, classroom, locker room, bathroom, social media, etc.) *
Describe the incident as best as you can, names of persons involved or bystanders. The more information you can give, will help us to investigate the incident. All information is kept confidential. *
Follow up: Is there any one you would like for us to follow up with (yourself or designated person) please let us know who and how to contact them. This is optional.
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