Student/Staff Incident Report
Discrimination or Bias Incidents
Any form of discrimination based on race, color, gender, gender identity, sexual orientation, religion, national origin, disability or any other category protected by state or federal law is not tolerated. Indian Hill Schools will promptly investigate and respond to all allegations of discrimination, including harassment and retaliation, to the fullest extent possible and take appropriate disciplinary, corrective, and remedial measures necessary to ensure a safe and equitable learning and workplace environment for all school community members.  


What is an incident of discrimination or bias?
Any time a member of our community is treated differently or disadvantaged because an aspect of their identity puts them in a protected class, it may be an incident of discrimination or bias.  Discrimination might take the form of subtle bias, hateful speech in the form of insults or epithets, or ongoing harassment or retaliation for a past event or report. Some incidents of bullying, or repeated targeting of another person in an unwanted manner, may also be acts of discrimination.  When incidents of possible discrimination or bias do occur, we are committed to conducting a full investigation to determine what harm has been done, how it can be fully addressed, and ways in which it can be prevented from occurring again.

Sign in to Google to save your progress. Learn more
Date of Incident *
MM
/
DD
/
YYYY
Time of Incident
Time
:
Your Role in the Incident *
Location of Student Involved *
Name of person(s) who committed act of bias/discrimination
Name of person who received bias/discrimination
Bias category
Check all that apply
Bias type
Check all that apply
Please describe the incident. *
Is the alleged discrimination still continuing? *
In your opinion, how could this be resolved? *
What is your preferred method for follow-up on this report? (please provide contact information below) *
Your Full Name (Optional)
Your Phone Number (Optional)
Your Email Address (Optional)
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Indian Hill Exempted Village Schools. Report Abuse