Anonymous Reporting Form

You may submit this form without giving your name. Please share as many specific details as you can so we can understand and respond to your concern. Because this form is not monitored continuously, do not use it for an immediate emergency. If someone is in immediate danger, call 911. During the school day, tell a school administrator, counselor, teacher, or school resource officer right away.

You may choose to provide contact information at the end if you would like someone to follow up with you. Providing it is optional. Anonymous reports can be harder to investigate when there are limited details. 

Sign in to Google to save your progress. Learn more
What is your concern about?
Choose the description that most closely aligns. 
Which school is this about?
What is your connection to the concern?
Clear selection
When did this happen, or when did you become concerned?
Where did it happen?
(school bus, online, off campus, if at school - where?)
Please describe what happened or what is concerning you.  *
Include as many details as possible and factual information. 
Who may need help or protection? Include names or identifying details if you know them.
Who else was involved or may have witnessed it?
Have you already shared this concern with a school employee?
Clear selection
Is there any other information that would help us understand or look into this?
OPTIONAL: Would you like to provide a name, phone number or email? This would be used to ask additional clarifying questions, if needed or follow up.  Your name will remain confidential to the administrator receiving the survey and conducting the investigation. 
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Greenwood Lake Union Free School District.

Does this form look suspicious? Report

Google Forms