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TISD Crisis Form
11 Questions
1) Your Name- NOT REQUIRED
(optional)
2) Your relationship to the person who was bullied, harassed, threatened of in a crisis.
Required
*
Select an option
3) Type of Incident
Required
*
Select an option
4) If you selected other above, please provide description.
(optional)
5) Who was Bullied, Harassed, Threatened, or in a crisis? (Name and Grade)
Required
*
6) Who committed the bullying, harassing, threatening, or is causing a crisis? (Name and Grade) - not Required
(optional)
7) When did the incident happen or when is the incident supposed to/predicted to happen?
Required
*
8) Where did the incident happen or where is the incident supposed to/predicted to happen?
Required
*
9) Briefly describe the incident.
Required
*
10) Any other information that you would like to share,
(optional)
11) By selecting True (or False), I declare that this report is true (or false) to the best of my knowledge and belief, and that I understand that the contents will be used to assist students in need. *
Required
*
True
False
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TISD Crisis Form
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