Report an Instance of Bullying, Harassment, or Intimidation

For families needing interpreting services to make a bullying report, you can call the HCPSS Call Center and someone will take the report for you.

Please tell us about yourself

Reporter

You can submit your report anonymously, but it will severely limit the ability of administrators to investigate the issue. If you do choose to include your information, it will be held in confidence.

Submit this report anonymously.

Which school does the targeted student attend?

Alleged Targeted Student(s)		Order
	Person Name School Age Days absent as a result of the incident (if known)	Weight for row 1

Alleged Witness(es) (if known)		Order
	Person Name Student School Age	Weight for row 1

Alleged Offender(s) (if known)		Order
	Person Name Student School Age Days absent as a result of the incident (if known)	Weight for row 1

On what date(s) did the incident happen?		Order
	Date	Weight for row 1

Report an Instance of Bullying, Harassment, or Intimidation

Please tell us about yourself

Alleged Targeted Student(s)

Alleged Witness(es) (if known)

Alleged Offender(s) (if known)

On what date(s) did the incident happen?

Physical Injury

Psychological Injury