Anonymous Bullying Reporting
Please fill out the following form to report bullying behavior you have experienced and/or observed. This is also a form for parents to share concerns they would like to address. Please understand that this form is completely anonymous unless you feel comfortable leaving your name and information below.
Sign in to Google to save your progress. Learn more

In order to be considered bullying, the behavior must be aggressive and include:

An Imbalance of Power: Kids who bully use their power—such as physical strength, access to embarrassing information, or popularity—to control or harm others. Power imbalances can change over time and in different situations, even if they involve the same people.

Repetition: Bullying behaviors happen more than once or have the potential to happen more than once.

Bullying includes actions such as making threats, spreading rumors, attacking someone physically or verbally, and excluding someone from a group on purpose.
Please describe your concern and who is being bullied. *
Where did the concern take place? At school, and where in the school? Online? On the bus? *
What kind of bullying do you feel describes the situation? *
Required
How are you involved? *
Who was involved? Please include observers. *
Has something like this happened before? *
If this has occurred several times before, how many times would you guess it has, and can you give an example?
How did you feel before the incident? During incident? After incident? *
Were you threatened with violence or humiliation if you reported the incident? *
Do you have a trusted adult at school or home you feel comfortable sharing this information? *
If you feel comfortable leaving your name and a way to contact you please do so below. This information will be kept strictly confidential, and will not be shared with those involved. This will also help us in the event we need further information.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Lewiston Consolidated School. Report Abuse