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Ravenwood Anonymous Report Form
If this is an emergency situation, please notify an adult immediately.
This form is for students who have a concern they would like to share with an administrator or counselor while staying anonymous. Your email address is NOT being collected, therefore we will not be able to contact you for follow up unless you leave your name.
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* Indicates required question
What type of concern are you reporting?
*
Choose
Drugs or Alcohol (inculding vaping or cigarettes)
Harassment or Bullying (direct or online)
Suicide or Self-harm (self or others) Please report this directly to an adult if possible.
Threat (verbal, physical, or weapons)
Details of the concern (if applicable)
Your answer
Location
*
Choose
Bus
Classroom
Commons area
Gym
Hallway
Home
Library
Locker Room
Lunch area
Online/Phone/Social Media
Outside/Parking lot
Stairwell
Other
Location - please provide additional details if needed.
Ex - Specific Hallway or Bathroom Location, Bus Number, Social Media App, etc.
Your answer
What day did your concern occur?
If the incident is ongoing, please use the date that you became aware of it.
MM
/
DD
/
YYYY
Approximately what time did your concern occur?
Time
:
AM
PM
What is(are) the name(s) of the person(s) being harmed?
Your answer
What is(are) the name(s) of the person(s) causing the harm?
Your answer
Names of any witnesses to this report.
Please list name(s) of any other person(s) with knowledge of this incident.
Your answer
Please provide the names of any adults that have been notified about your concern.
Your answer
Do you have any evidence of the concern, texts, pictures, etc?
Please see an administrator, counselor, or teacher to share any evidence you may have.
Yes
No
Clear selection
What is your name? (Optional)
Your answer
Email Address (Optional)
This form does not automatically collect any identifying information, therefore we will not be able to follow up with you if you do not provide your name or email address.
Your answer
Thanks for helping make RHS a safe school.
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