Matthews Elementary Bullying Report
This report is anonymous and confidential and should only be used when you are feeling a real concern for the physical, social, or emotional well-being of yourself or another student. If you feel this is an emergency, we encourage you to also report this immediately to a trusted adult. Once this report is submitted, it will be reviewed by the SRO, Social Worker, Counselor, or Principal.
Please type the name of the student about whom you are concerned.
Where did the incident you are reporting happen?
Please describe the problem/incident you witnessed or experienced. Give as many details as you can.
What is the approximate date and time this incident occurred?
If you would like to leave your name, you may do so below. This is NOT required.
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This form was created inside of New Madrid County R-1 School District.
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