Bias Incident Reporting Form
If you or someone you know has directly or indirectly experienced bias in the school community, please complete this form to report it.

You may choose to keep the names of those involved a secret. This is a chance for everyone to feel supported, including keeping the reporter's sense of safety/comfort level intact, as well as using this as a teachable moment for restorative justice.

This form should only be used for genuine reporting.
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BIAS is prejudice or judgment in favor of or against one thing, person, or group compared with another, usually in an unfair way. People can be biased in their thinking and/or actions.
Name
Email Address
Date of Incident: *
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DD
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YYYY
Approximate Time of Incident: *
Time
:
Location of the Incident: *
Description of what happened. Please be as detailed as possible. Please include all names of people involved if known. *
If you witnessed the incident, who are you reporting in support of? Was this directed at you or someone else? *
(Optional) Which trusted adult in the building do you prefer to reach out to you?
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