BSMS Bullying Form
Bullying is unwantedbehavior that involves a real or perceived power imbalance. Whether ithappens in the hallways or online, such behavior can create hostile learningenvironments that interfere with students' academic performance, and emotional andphysical well-being. Harassment is motivated by real or perceivedcharacteristics, such as race/ethnicity, gender, religion, sexual orientation,physical or mental ability, or socioeconomic status. Bullying behavior isthreatening, intimidating and occurs repeatedly over time with the intent tocause harm. Please answer the following questions honestly andspecifically. Once a report has been submitted, an investigation of theincident will begin promptly. The matter will be handled as confidentiallyas possible.
Location of Incident:
Please provide details about the incident:
What happened? Where did it happen? Who was involved/witnessed the incident?
Have you spoken to anyone about this incident?
If Yes, who have you spoken to:
Has this happened before?
If Yes, please describe any previous incidents:
Should be Empty:
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