Central Academy Anonymous Bullying Form
This form is anonymous and confidential and should only be used when you are feeling a real concern for the physical, social, and emotional well-being of yourself or a fellow student. Upon submission of this form a request will be sent anonymously. If you feel this is an emergency, we encourage you to report this immediately to a trusted adult.
Please type below the name of the student about whom you are concerned. *
Where did the incident you are reporting happen? *
Please describe the problem or incident you witnessed/heard about which you are concerned. *
What is the approximate date and time this incident occurred? *
If you would like to leave your name, please do so below.
This is optional and not required to submit the form.
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