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Report Challenging Behavior

This form is for students, parents or guardians of students enrolled in the school, and school employees to report any alleged challenging behavioral incidents. 

Challenging behavior is behavior that negatively impacts school climate or interferes, or is at risk with interfering, with the learning or safety of a student or the safety of a school employee.  This form should also be used to report alleged bullying incidents, meaning: unwanted and aggressive behavior among children in grades kindergarten to twelve, inclusive, that involves a real or perceived power imbalance.

Complete this form electronically, or in writing, or go to your school climate specialist/or an administrator who will assist you with completing this form.  A confirmation of receipt of the "Challenging Behavior Reporting Form" will be provided to the individual who completed this form within three school business days, and the behavioral assessment will be finalized within a reasonable amount of time.

All completed reports require a response from the school climate specialist/or administrator, and every student, parent or guardian, and school employee who completed this form will receive a copy of the "Response Process(es) Notification Form" describing the action steps taken, within three school business days after an assessment has been completed.

This form does not collect email addresses. If you do not provide an email address you not get the "Response Process(es) Notification Form"

If this is an emergency, and you feel that you or someone else is in imminent danger, please call 911, or your municipal police department.

Required

I am making a report as a:
Do you want to make an anonymous report?required
Namerequired
First Name
Last Name
Namerequired
First Name
Last Name
*If more than one person was involved, please provide all their names.
Where did the incident occur? *Check any boxes that apply.
*Check any boxes that apply.
Must contain a date in M/D/YYYY format
Check any of the following statement that may describe or include what happened during this incident:

This form does not modify or eliminate any rights or obligations under state and federal laws, including, any constitutional and civil rights protections, or any applicable policies and procedures or collective bargaining agreements.  All students' private and personal information will remain confidential throughout this process, subject to any waiver rights or disclosure responsibilities as permitted or required by law.

Please note:

When a student exhibits challenging behavior, our priority is to ensure the safety of the students and the school, and to work with the student(s) to prevent the recurrence of such behavior, including making amends for any challenging behaviors that occurred.  Federal law protects the privacy of each student.  Therefore, you cannot be provided with any specific information concerning the student alleged to have engaged in the challenging behavior.