Editing previous response:

Please fix the highlighted areas below before submitting.

Anonymous Counselor Contact

Please complete the form below. Required fields marked *

Student(s) Involved*

Answer required for "Student(s) Involved"

Grade(s) of student(s) involved*

Please check all that apply

Answer required for "Grade(s) of student(s) involved"

PK-4th

5th-7th

8th

9th-10th

11th-12th

Please describe, in as much detail as possible, what happened.*

Answer required for "Please describe, in as much detail as possible, what happened."

Where did the incident occur (if known)?

Answer required for "Where did the incident occur (if known)?"

Do you know of any witnesses involved?

If so, please provide as much detail as possible about these individuals.

Answer required for "Do you know of any witnesses involved?"

List evidence if any (for example, letters, photos, texts, etc.)

Answer required for "List evidence if any (for example, letters, photos, texts, etc.)"

Attach any screenshots or images here.

Answer required for "Attach any screenshots or images here."

Choose a file or drag it here.

If you wish to remain completely anonymous, please leave the email address field below BLANK.

Confirmation Email

Answer required for "Confirmation Email"