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

Alleged Witness(es) (Include all known details.)		Order
	Person Name Student School Age	Weight for row 1

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

Where did the incident happen? (Choose all that apply.)

On school property

On a school bus

Digital device on school property

Digital Device during virtual learning

On the way to/from school

Off school property or at a school-sponsored activity or event

Digital device off school property

Other

Report an Instance of Bullying, Harassment, or Intimidation

Please tell us about yourself

Alleged Targeted Student(s)

Alleged Offender(s) (Include all known details.)

Alleged Witness(es) (Include all known details.)

On what date(s) did the incident happen?

Physical Injury

Psychological Injury