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HDISD Online Bullying Report Form
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Bully's Name
Your answer
Victim's Name
Your answer
Date of incident
MM
/
DD
/
YYYY
Time of incident
Time
:
AM
PM
How do you know the bully?
Your answer
Where did the incident occur?
Your answer
Was there anyone around who may have witnessed what happened? If so, what is their name?
Your answer
Describe what happened.
Your answer
Your name and contact information.
Your informatiion is optional but appreciated. WE PROMISE TO PROTECT YOU.
Your answer
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