Report Bullying, Harassment and Discrimination

Please use the secure form below to report an incident(s) of bullying, cyberbullying, or retaliation.

If you prefer, you can also file an anonymous report of bullying, cyberbullying or retaliation by leaving a voice mail message on the division's HOTLINE 757-890-5000. Reports to the HOTLINE are retrieved daily and investigated by the proper authorities. All calls are confidential.

Person Reporting Incident (Note: If this is an anonymous report, leave name and phone number blank.)
Name (Optional): Telephone (Optional): Are you a:* Required
Individuals Involved in Incident
Name of victim:* School: Grade Level: Is he/she a student?
Name(s) of the alleged offender(s):* School (if known): Grade Level: Is he/she a student?
Name(s) of other witnesses (if known): School (if known): Grade Level: Is he/she a student?
Were you an eyewitness to this behavior?    
Details of Incident
On what date did the incident happen?    
Where did the incident happen? (check all that apply)*    

Check the box next to the statement(s) that best describes what happened (check all that apply):*

Please describe the incident in as much detail as possible:*

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