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

Thank you for reporting this incident. We appreciate your concern. When you click "Submit Form" this will be sent to the campus administrator.
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Date of Incident *
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Date of Report  *
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YYYY
Who was the person(s) engaged in bullying?
 
 *
Grade of person(s) who engaged in bullying?
 *
Who was being bullied?
 *
Grade of person who was being bullied?
 *
What type of bullying? *
Required
Where did the incident take place?
 *
Other location details: (Please explain the specific location details such as which hallway, where on the Internet, what restroom, etc)
Describe what happened with as many details as possible.
 *
Person reporting the incident:(OPTIONAL). Please use your full name.
 
May we contact you for more information on this incident?
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