Handle With Care- Polson, MT
This form is for reporting officials ONLY.

Please fill out this form to help Polson School District better serve our students by letting us know when a student has been involved in a traumatic event or accident. We will use this information to support this student and ensure his or her needs are met at school.

Fill out one form per student. This information will be sent to the school counselor and principal and kept confidential.
Thank you.

Student's name (first last)
Your answer
Age
Incident Date
MM
/
DD
/
YYYY
Reporting Agency
Contact Information of Person Making Report
Your answer
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