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Report Bullying

Counseling

You may fill out the form below or print the form to return to a counselor or administrator. Find the printable version here.

Report Bullying

  • MM slash DD slash YYYY

  • Student(s) who participated in bullying behavior:

  • Student(s) who was bullied:

  • Did anyone else witness this situation?

  • About the Incident

  • MM slash DD slash YYYY

  • What happened: “I was…” or “I saw someone get…”