DASA/safety incident reporting form
Jericho UFSD is committed to providing a safe, supportive environment free from harassment, bullying or discrimination. The District encourages the involvement of staff, students, parents and community members in the implementation and reinforcement of the Dignity for All Students Act (DASA). If you believe you, or someone else, has been the target of harassment, bullying – including cyberbullying – or discrimination, please use this form to report all allegations. You may also use this form to report safety incidents you want to make District personnel aware of.
You can complete this form online and it will automatically be directed to the school administrator. Or you can complete this form and return it to the school administrator or Dignity Act Coordinator. Administration will review and respond to each incident in the context of the student Code of Conduct.
*All complaints will be treated in a confidential matter. Anonymous reports may limit the district’s ability to respond to the complaint.
**False reporting of incidents may result in disciplinary consequences and may be reported to an appropriate law enforcement agency.