Describe the basis for your report. Include information about the incident(s), participants, background to the incident, and any attempts you have made to resolve the problem. Please note relevant dates, times and places.
Your answer
Based upon information provided, are there any other district policies implicated?
Clear selection
Explain.
Your answer
Indicate if there are witnesses who can provide more information regarding your report. If the witnesses are not school district staff or students, please provide contact information.
Your answer
Have there been previous incidents?
Clear selection
If “yes”, please describe the behavior of concern, the approximate dates and the location:
Your answer
Were these incidents reported to school employee(s)?