WOHS Bully/Harassment Report
Directions: If you feel that you witnessed an act of bullying, please fill out the form below. You can report your name OR can choose to remain anonymous. If you'd prefer to talk in person, you may visit any administrator or counselor.
Describe your Role at WOHS
What is your name? (optional)
Your answer
List the name or names of the alleged bully (if you don't know the name(s), write, "unknown")
Your answer
Describe what happened and who was involved in the reported incident (please include names of possible witnesses):
Your answer
Describe your role in the matter.
Required
Were threats communicated? If so, please list how the threats were communicated (text, verbally, written, use of other technological method):
Your answer
Is there outside evidence of this activity/event? If so, what is it (notes, videos, text messages, postings) and where can it be found?
Your answer
Prior to completion of this form, was this action reported to or observed by another adult? If so, to whom was it reported?
Your answer
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