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Utah Code 53G-10-103 (HB374)Reporting Tool
This reporting tool is to be completed by LEAs who have received a complaint regarding instructional materials according to:
53G-10-103(HB374)
Sensitive instructional materials
Please only complete this form after a decision has been made about the instructional material's retention or removal.
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* Indicates required question
Email
*
Your email
First and Last Name
*
Your answer
School District or Charter
*
Your answer
Job Title/Position
*
Your answer
Date Complaint Received
*
MM
/
DD
/
YYYY
Level of Complaint
*
Classroom Level
School Level
District Level
If school- or classroom-level complaint, name of school.
Your answer
Title of Material
*
Your answer
Author of Material
*
Your answer
Complaint Submitted By:
*
Parent
Educator
Administrator
Other Employee
Community Member
Organization
Other:
Required
Reason(s) provided for complaint. Be specific -- feel free to copy/paste from complainant's request.
*
Your answer
District/School Action Taken (check all that apply):
*
Conversation (written or verbal) with complainant
Reconsideration Committee
Internal Review
Already reviewed in the past year
Required
Was the book reviewed as a whole?
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Yes
No
Were parents who are reflective of the members of the school's community included in the determination?
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Yes
No
District/School Decision Made:
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Material retained
Material retained with exceptions
Material removed from a specific school
Material removed from LEA
Material removed from eBook/audiobook Catalog (i.e., Sora, Overdrive, etc.)
Other:
Required
Date of Final Decision
*
MM
/
DD
/
YYYY
Provide the rationale for retaining or removing the material.
*
Your answer
Additional Notes (Optional)
Your answer
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