Incident Form: See Something, Say Something
When a person really needs help or there is a safety threat at school we hope you will step up and send in a report. Reports should include anything that may cause harm or put others in danger. After you fill out the form below and click the submit button at the bottom, an email will be sent to a school administrator with all of the details from your report. Sending in a false report makes it harder for your school to help the people who really need it. Thank you for working with us to make our schools safer for everyone.
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School
Was the incident (select all that apply)
Was the incident committed by
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Was the incident directed towards
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Location of incident
Description of the incident.  Please be specific providing as many details as possible.
How many times did the incident occur?
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Date of incident
MM
/
DD
/
YYYY
Time of incident
Time
:
Names of person/s your complaint is about (respondent)
Who was being harmed?
Were there any witnesses?​
Clear selection
If yes, who witnessed the incident?
Your Name (complainant) Reports may be made anonymously, but formal disciplinary action may not be based solely on an anonymous report.
How to contact you (email/phone)
Are you a student, parent, employee?
Clear selection
Are you reporting this for someone else?
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Did you report this already?
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If you reported this already, who did you report the incident to?
What are you requesting as a resolution?
Submit
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