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Bullying Documentation Forms

Bullying Documentation Forms

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The form that must be filled out each time a complaint of bullying or harassment is made.
The form that must be filled out each time a complaint of bullying or harassment is made.

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Categories:Types, Legal forms
Published by: The Route 60 Sentinel on Sep 28, 2012
Copyright:Attribution Non-commercial

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12/16/2014

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1
Bullying / Harassment DocumentationAnti-Bullying / Harassment Complaint Form
Name of complainant:Position of complainant:Date of complaint:Name of alleged harasser or bully:Date and place of incident or incidents:Description of misconduct:Name of witnesses (if any):Evidence of harassment or bullying, i.e. letters, photos, etc. (attach evidence ifpossible):Any other information:I agree that all of the information on this form is accurate and true to the best of myknowledge.SignatureDate:
 
 
2
Bullying / Harassment DocumentationAnti-Bullying / Harassment Reporting FormInterview with Person Making Charge
Student’s name making charge:
DateDate incident occurred:Location incident occurred:Name of person being charged:
Interview with Person Being Charged
Please describe this incident:Have there been previous incidents? If so, please describe.Have previous incidents been reported to a teacher, counselor, or principal?
 
 
3
Bullying / Harassment DocumentationAnti-Bullying / Harassment Reporting FormInterview with Person Making Charge (Continued)
 
What have you done to deal with the harassment?Were there any bystanders/witnesses? If so, what are their names and what was theirlevel of involvement?Was the person being charged told to stop the behavior? If so, by whom?What would be a positive outcome to this situation?

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