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Bully Report

Please complete the form below. Required fields marked with an asterisk *

This form is a safe, online tool designed to help improve the culture of our school. Please use this form to report any incidents of bullying at Westgate. The form is sent to the Assistant Principals, Counselor and Restorative Practices Coordinator, and someone will respond as quickly as possible.

Bullying means that someone has done something to you (or someone else) that meets all the following criteria: 1) it is repeated, 2) it is intended to harm/ hurt, 3) there is a power imbalance.

If what you are reporting does NOT meet these three things, it might not be bullying. Please start with the following steps:

1) Report the incident or mean behavior to your Advocate.

2) Seek the support of the Counselor, if necessary.

Contact Information

What is your name?

Answer Required

Please use this space to describe the incident. What happened and who are you reporting?*

Answer Required

Where did the incident happen?*

Answer Required

When did the incident happen (date/ time of day/ etc.)*

Answer Required

What was happening before the incident occured?

Answer Required

What happened after the incident occured? (Did you try using "Enough?" Did you tell anyone else?)

Answer Required

Who else was involved? (Bystanders, witnesses, etc.)

Answer Required

Is this the first time this behavior has occured? Or is this behavior REPEATED by the same person?*

Answer Required

First Time

Repeated

Was this incident targeted at you or someone else?*

Answer Required

It was accidental - not targeted.

It was targeted at me, and meant to hurt me.

It was targeted at someone else, and intended to hurt him/her.

Is there an imbalance of power? (Ex. Is one person older than the other? Was a group involved?)*

Answer Required

Yes

I don't know

Confirmation Email

Enter your email address here if you'd like to receive a confirmation upon submitting the form.

Email Required