Report Bullying

Report Bullying
Please complete this form with as much information as you feel comfortable sharing to tell us about a situation you or someone you know is experiencing.

Please be aware that all information provided will not be shared with anyone outside of LICAB and is STRICTLY CONFIDENTIAL.

Once submitted, a LICAB Response Agent will contact you within 24 hours.
Your Information
Your Name*

First NameLast Name
Your E-Mail*
example@example.com
Your Phone Number*
Please enter a valid phone number.
Relationship to Child*
Child Information
Child Name (Voluntary)

First NameLast Name
Child Age*
School District*
School Name*
Please provide as much information as possible regarding the struggles with bullying. Please be as specific as possible.*
After clicking submit, a member of our Response Team will reach out to you to discuss the situation further within 24 hours.
Should be Empty: