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DMS Bully Form

Please complete the form below. Required fields marked *

Bullying, harassment, or intimidation are serious and will not be tolerated. This is a form to report alleged bullying, harassment, or intimidation that occurred on school property; at a school-sponsored activity or event off school property; on a school bus; or on the way to and/or from school, in the current school year. If you are a student victim, the parent/guardian of a student victim, a close adult relative of a student victim, a school staff member or a witness to a bullying event and wish to report an incident of alleged bullying, harassment or intimidation, complete this form and submit it online. You may choose to do so in complete anonymity.

Bullying, harassment, or intimidation means repeated intentional conduct, including verbal, physical, or written conduct or an intentional electronic communication that creates a hostile educational environment by substantially interfering with a student’s educational benefits, opportunities, or performance, or with a student’s physical or psychological well-being.

Person Reporting the Incident

Contact Information
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People Involved

Student Victim's School*
Offender #1 School
Offender #2 School

When did the incident take place?

Where did the incident take place?

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Select the statements(s) that best describe the incident

Choose as many as applicable*