GRHS Wellness Tip Line
* Required
Email address
*
Your email
If you have a concern regarding a student's wellness: mental health, chemical use, social isolation, bullying, harassment, etc. and would like to report this information, please complete the following items to the best of your knowledge. You may also report your concern in person to an administrator, counselor or other school staff.
Please note that this form can be submitted anonymously. However, the more information you provide the better we are able to investigate and support the student regarding your concern.
Knowingly making a false report is a violation of school policy.
All submissions will be taken seriously and addressed during school hours.
Note: This is not a crisis line. Please note that reports received during the summer may not be addressed in a timely manner.
IF THIS IS AN EMERGENCY, CALL 911
IF YOU ARE IN NEED OF CRISIS, CALL 211 OR TEXT "MN" TO 741741
Incident Report
Please describe your concerns in as much detail as possible:
*
Your answer
Please include name(s) of the individual(s) involved:
Your answer
Indicate the grade(s) of the individual(s):
*
Grade 9
Grade 10
Grade 11
Grade 12
Unknown
Location of Incident:
Bathroom
Classroom
Hallway
Lunchroom
Offcampus
Parking Lot
Other:
Date and time of incident
MM
/
DD
/
YYYY
Time
:
AM
PM
If you know of other witnesses, please include their names below:
Your answer
Contact Information
Most of the following information is encouraged but not required. The more information you are able to provide, the better we are able to investigate and support the student regarding your concern.
Reporter
*
Student
Family Member
Other:
Name:
Your answer
Phone Number:
Your answer
Email Address:
Your answer
I would like to be contacted for a follow-up:
*
Not at this time.
I have included my contact information and would like to receive a follow-up call or email
This information will be used to provide a safe, supportive environment for our students. The information will be used to help students with any issues/concerns that are raised. Information may be shared with educators who have a need to know in order to help support our students or with outside agencies who are required to be alerted or who may assist students as well. You are not under any obligation to provide information but we encourage you to provide information that may help students have a safe, productive educational environment.
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