Safety Concerns
This form is available for any student, staff, and family/community member who has a safety concern related to a SASED student, staff member, or school/program.
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I am a: *
What SASED program or service is involved in the concern? *
Event Description (include who, what, when, where and how do you know) *
Concern/Event Type:
Who are you concerned about?
Please provide as much of the following information about the person(s) of concern as possible:
Name of first person of concern:
Involvement of person 1:
Grade & Age of person 1
Race/Ethnicity of person 1
School/Location of person 1:
City/Town of person 1:
Description of Physical Appearance/Clothing of person 1:
Is there another person involved? *
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