School Bullying Incident Communication Report
Date of Report
Reporter Name
Reporter Role (e.g. Teacher, Parent, Student)
Contact Information
Name(s) of Student(s) Involved
Date and Time of Incident
Location of Incident
Type of Bullying
Physical
Verbal
Social
Cyberbullying
Other
Description of Incident
Immediate Action Taken
People Notified (e.g. Parents, Principal)
Additional Notes