Report Bullying
REPORT a BULLYING INCIDENT

While the district already has many programs to help students deal with challenges such as bullying behaviors, stress, peer pressure, and family problems, Report a Bullying Incident helps break the code of silence often experienced by students because it allows them to report concerns to administrators anonymously.

IMPORTANT NOTE: This is not a crisis line. In cases of emergency, please call 911!

Please complete this form to the best of your knowledge so we can assist you.
This information will be kept confidential with the campus administrator and/or director and/or district administrator.

Please Fill Out The REPORT a BULLYING INCIDENT Below
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Time of Incident *
Time
:
 Where did the incident take place? *
 Possible witnesses:
Grade of the person who was being bullied?
 Who was the person or persons engaged in bullying? *
Date of Incident *
MM
/
DD
/
YYYY
 What type of bullying? *
Required
 Which campus? *
 Who was being bullied? *
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This form was created inside of Chireno ISD. Report Abuse