Safety Reporting Form
Please use this form to report any issues that you have seen in your school or district regarding compliance with COVID-19 safety protocols.

Please review the State reopening plan(s) here:
Your school board’s COVID-19 Policy may also contain additional safety measures.
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My concern relates to: *
Check all that apply.
Tell us about your concern. *
To your knowledge, does this involve a violation of your school district's policy? *
Have you reported this to your supervisor or to Central Office? *
If you answered yes above, what did they say in response?
Have you reported this to the LDOE? *
You can report a concern to the LDOE at this email:
Has anyone else witnessed this issue? Who? *
What is the name of your school District? *
First and Last Name
Personal Email
Please provide your personal email, not your work email.
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