Listening Locker/Bullying Report Form
At Hidden River Middle School, we believe that bullying, harassment and/or other forms of intimidation are very serious acts and they will not be tolerated in our school. Bullying is defined as ANY means of written, electronic or verbal expression, physical act or gesture, or patterns thereof, that is intended to cause distress or harm which interferes with a students ability to perform in school.

Please complete this form to report an incident of bullying that involves a member of the Hidden Middle School Community. This form will be reviewed by the School Counseling team.
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Today's Date: *
Person reporting the incident. It is okay to remain anonymous.
Who is the victim or target of this incident? *
Who is the person accused of bullying or harassment? *
When did the incident happen? *
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Where did the incident happen? *
What happened? Please explain in detail. *
Where you or anyone else injured during this incident? *
Are there witnesses to the incident? If so, please list their name(s) and grade level. *
Once your form has been received, a counselor will connect with you about the incident. If you are not a Hidden River student and would like to be contacted via phone or email, please provide your contact information below. Thank you
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