RFHS Anonymous Reporting Form
NOTE: Information included in this form goes privately to the Campus Critical Incidence Response Coordinator. All submissions are reviewed and investigated.

The following form collects information on incidences of bullying, threats to the campus, sexual assault, sexual harassment, dating/domestic violence, or stalking. If you wish to report something not covered by these topics you may do so in the narrative section

If you would like to speak privately to someone, please call (361) 790-2220 x2046. You can also e-mail tgraham@acisd.org.

If this is an emergency situation, please ensure the safety of affected individuals before completing this form.
Your Name or Anonymous
Email Address
Phone Number
Today's Date *
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DD
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Affiliation with the Incident *
Type of Incident(s) *
Required
Have you reported this incident to anyone else at Rockport-Fulton High School before today? *
The following questions ask about the incident(s) that you are reporting. If any of the information is unknown, please leave the question blank.
Be as detailed as possible.
Victim's Name
Victim's Gender
Clear selection
Victim's Age
Date of Incident
Approximate Time of Incident
Victim's Affiliation with RFHS
Clear selection
Include any additional relevant information you feel is important.
Alleged Perpetrator's Name
Alleged Perpetrator's Gender
Clear selection
Alleged Perpetrator's Age
Alleged Perpetrator's affiliation with RFHS
Clear selection
Location of the Incident
Clear selection
How do the victim and alleged perpetrator know each other?
Provide a description of the incident (Who, What, When, How, & Why) *
Do you wish for a RFHS counselor or administrator to contact you?
Clear selection
Thank for your time and willingness to make RFHS a safe environment for education.
Submit
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