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)
List the name or names of the alleged bully (if you don't know the name(s), write, "unknown")
Describe what happened and who was involved in the reported incident (please include names of possible witnesses):
Describe your role in the matter.
Witness (friend of the victim)
Witness (friend of the bully)
Witness (no relationship to the victim or bully)
I didn't see it happen. I heard about this from someone else.
Were threats communicated? If so, please list how the threats were communicated (text, verbally, written, use of other technological method):
Is there outside evidence of this activity/event? If so, what is it (notes, videos, text messages, postings) and where can it be found?
Prior to completion of this form, was this action reported to or observed by another adult? If so, to whom was it reported?
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