Student Anonymous Incident Report
We want to give you several ways to resolve issues and to help you feel safe and comfortable while attending Jim Ned CISD schools. If you are more comfortable reporting a situation anonymously, please complete the form below.

(1) If you are too uncomfortable about reporting personal issues, use this form to quickly report incidents related to  student depression, family problems, self-harm, drugs, gang-related issues, harassment, weapons on campus or unusual student behavior which may warrant immediate attention by school officials. You will NOT be contacted unless you opt to give your contact information.

Report bullying on the "Bully Report Form" (http://schools.jimned.esc14.net/page/DebbieHarris-Bully%20Report).

(2) If you have suggestions, recommendations, or important critical observations that you feel might help the district or might assist the district in becoming more safe and productive, please feel free to submit this anonymous form.

Thank you for taking time to make Jim Ned CISD Schools a better place for ALL.

Sign in to Google to save your progress. Learn more
Name (optional)
Date of Incident *
MM
/
DD
/
YYYY
Contact Information (optional)
phone number or email address
Concern, suggestion, critical issue *
Please explain in as much detail as possible the issue, concern, or suggestion that you would like the district to address. Thank you for your time in preparing this statement and all the details.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Jim Ned CISD.