Report Bullying or Unsafe Behavior
Use this from to report bullying, sexting, substance use/abuse, or any unsafe or unhealthy behavior.
Reporter's Name *
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Bully's Name *
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Student Bullied *
Your answer
Date(s) of Incident:
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Time of Incident:
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Location bullying occurred:
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Witnesses:
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Adults made aware of the event:
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Check All That Apply
Description of the incident:
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If this report involves social media, keep/save any evidence for the counselor or principal.
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This form was created inside of Shawnee Heights USD #450. Report Abuse