JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Anonymous Reporting Form for Bullying Situations
Please use this form to report any cases of bullying. Fill in as much information as possible to help us investigate the situation. You may submit this form anonymously or add your name at the end.
Sign in to Google
to save your progress.
Learn more
Student who is suspected to be the victim of alleged bullied
Your answer
Name(s) and grade(s) (if known) of the alleged bully(ies)
Your answer
Were any threats communicated?
yes, verbal threats
yes, physical threats
yes, online threats
yes, other type of threat
no, no threats were made
Clear selection
Do you have evidence to support your report?
yes
no
Clear selection
What is the evidence?
Your answer
Briefly describe what was witnessed or what the student reported, including locations, times, dates and surrounding circumstances.
Your answer
Prior to the submission of this form, has this alleged bullying been reported to any school employee? When and to whom?
Your answer
Optional: Name of person filing report (If you would like to remain anonymous, please leave this blank.)
Your answer
Optional: Contact number (if non-student) of person filing out report
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
