BMS Anonymous Bullying Complaint Form
Please use this form to report incidents of bullying, sexual harassment, dating violence & sexual violence
Name of person filling out the report
If you don't want to leave your name, just enter "Anonymous"
Your answer
Date incident happened
Your answer
Name(s) of students/adults involved
Please list the name(s) of students and/or adults involved. Please list one name per line.
Your answer
Where did this this happen?
Your answer
Please describe what happened
Your answer
Were there any witnesses?
If yes, what are their names?
Please list the name(s) of any witnesses. Please list one name per line.
Your answer
Is this the first time this has happened?
If no, how many other times has this happened before?
Your answer
Other information about previous incidents or threats
Please add any additional information about previous incidents or threats
Your answer
Do you want to meet with Ms. Robidoux about this incident?
If yes, how can we contact you?
If you are not a student, please leave an email address or phone number that Ms. Robidoux can use to contact you
Your answer
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