Collier County Public Schools

What is bullying?
Bullying is systematically or chronically inflicting physical hurt or psychological distress on one more more students or employees.

The form below is completely anonymous.
For the purpose of this form, bullying encompasses bullying, harassment, and discrimination, including cyber incidents.

Victim's Name (Optional)	Grade
Accused Name	Grade
Witnesses	Grade(s)
School
Where did this incident occur?
When did this incident occur?
Please describe, in as much detail as possible, what happened. Include when it happened, why, and how.
Do you know any of the witnesses involved? If so, please provide as much detail as possible about these people.
List evidence of bullying, if any (i.e., letters, photos, etc.).

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