Anonymous Reporting Form

If you have information that you would prefer to report anonymously, please fill out the following form to the best of your knowledge and submit. For the purpose of this form, bullying encompasses bullying, harassment, and discrimination, including cyber incidents. Note that FLVS employees may not report child abuse anonymously but must follow the required reporting process as stated in the employee handbook.

What is being reported? *
1. Which school is this report for? *
1a. Please identify what brick and mortar school they belong to *
2. Who was being bullied, harassed, hazed, abused, intimidated or harmed? Please provide first and last name. *
3. Please indicate the date of this incident. 3. Please indicate the date of this incident. * / MM / DD YYYY
4. If known, please provide any known digital presence/identification (Twitter handle, Display name, Handle, username).
5. Describe what happened. Please give as much information as you can, including any witnesses. *
6. If known, how many times has this situation occurred? *
7. Please identify any adult or staff member who has been made aware of this incident.
8. Is there any evidence you would like to share (i.e., letters, photos, etc.)?

Attach Files
Please provide any additional information you feel is relevant.