Please use this report form to share any concerns regarding incidents of bullying. Bullying is when one person or a group of persons, targets another person with repeated direct or indirect negative actions over a period of time which are harmful to the victim either emotionally or physically.
Name of person completing this report
On what date (s) did the incident (s) happen?
Check the statement(s) that best describe what happened (choose all that apply).
Touch, including hitting or pushing
Getting another student to hurt the student
Teasing, name-calling, making hurtful remarks or gestures
Threatening or intimidating the student
Spreading harmful rumors or gossip
Cyber bullying (social media)
Damage/Steal personal property
Please provide a description of what happened. Please include location and any witnesses.
Should be Empty: