Anonymously Tell Someone

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An anonymous reporting form for bullying, safety issues, and other concerns.

Please select all concerns that apply.

Cheating / Academic Dishonesty

Depression and/or Anxiety

Drugs and/or Alcohol Abuse

Harassment / Bullying

Physical Abuse

Sexual Abuse

Suicide and/or Self - Harm

Verbal Abuse

Other

If you chose other as your concern, list it here.

Who are you concerned about? Please list your name or the name of the individual(s) that you are concerned about.

When did this incident occur? If applicable, list the incident date.

Is there a specific time this is taking place?

If applicable, name the individual(s) causing harm

Please provide us with as much detailed information about your concern or specific incident as possible. The more information we can gather, then the better we can help.

Is there anything else you would like for us to know?

This form will be submitted anonymously once you hit the "submit" button. Please feel safe in knowing that we will not share your name with the person you are concerned about unless you approve us to do so. There are cases where additional information is needed. Therefore, if you are willing to provide us with your name and a phone number or email address we may contact you at, please enter it below. If you still prefer to remain anonymous, you may leave this section blank.

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This form was created inside of Chester School Dist. 139. Report Abuse

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