Bullying Report Form

Reporting bullying or harassing behavior is the first step toward making our schools a safe place for everyone. Please report bullying if you are experiencing it, or witness it in school, on the bus, at school events, or online.

“Bullying" means engaging in written or verbal expression, expression through electronic means, or physical conduct that occurs on school property, at a school-sponsored or school-related activity, or in a vehicle operated by the District and that:

1.   Has the effect or will have the effect of physically harming a student, damaging a student’s property, or placing a student in reasonable fear of harm to the student’s person or of damage to the student’s property; or

2.  Is sufficiently severe, persistent, and pervasive enough that the action or threat creates an intimidating, threatening, or abusive educational environment for a student.

This conduct is considered bullying if it:

3.   Exploits an imbalance of power between the student perpetrator and the student victim through written or verbal expression or physical conduct; and

4.   Interferes with a student’s education or substantially disrupts the operation of a school.

For more information about bullying you may refer to the HSISD Handbook and HSISD Board Policies.

        Use the following form to report bullying. Fill it out online and it will be submitted directly to the appropriate district personnel. Reports are held in the strictest of confidence.

Campus * Required
Victim Name/s *Required
Name of Person Reporting
Relationship of person reporting to the victim
Phone number of person reporting
Accused Bully Name/s * Required (at minimum first name)
Location of incident * Required
Date and time of incident * Required
Describe what happened in as much detail as possible. * Required

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