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Bullying Report Form

Required

If you have experienced, witnessed, or are concerned about bullying, please complete this form. Reports are reviewed promptly by school administration. You may also contact your building principal or school counselor directly. 

If someone is in immediate danger or there is an emergency, call 911 or notify a staff member immediately.

I am a:
Reports may be submitted anonymously. However, providing your contact information may help us investigate more thoroughly.
Reporter's Name (Optional)
First Name
Last Name
Student who was bulliedrequired
First Name
Last Name
Person alleged to have bulliedrequired
First Name
Last Name
Must contain a date in MM/DD/YYYY format
Has this happened before?required
Where did it happen?required
Type of Bullying (check all that apply)required