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Revised 02/25/14 Initial Harassment/Intimidation/Bullying Form #1 Submitted by: Date Submitted: Must be submitted within TWO school days of verbal report. Use this form to report students who have
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How to fill out the HIB initial referral2014 revised:

01
Begin by accessing the HIB initial referral2014 revised form. This form should be available through your school or educational institution's administration office.
02
Carefully read through the instructions provided on the form. These instructions will guide you on how to complete each section of the referral form accurately.
03
Begin by filling out the basic information section. This includes providing the student's name, date of birth, grade level, and contact information.
04
Move on to the section where you need to describe the incident. In this section, provide a detailed account of the alleged harassment, intimidation, or bullying incident. Include specific dates, times, locations, and individuals involved, if known.
05
If there were any witnesses to the incident, make sure to list their names and contact information in the appropriate section.
06
Proceed to fill out the section that requires information about any previous discipline or interventions taken regarding the reported incident. Include details of any previous actions taken by the school or individuals involved.
07
Next, provide information about any medical, psychological, or counseling services the student has received as a result of the incident, if applicable.
08
If you have any supporting documents, such as emails, messages, or photographs related to the incident, make copies and attach them to the referral form. Note the attachments in the relevant section.
09
Lastly, sign and date the form to indicate that all the information provided is true and accurate to the best of your knowledge.

Who needs the HIB initial referral2014 revised?

01
Students who have experienced harassment, intimidation, or bullying incidents in a school or educational setting.
02
Parents or guardians of students who have been subjected to such incidents.
03
School administrators or staff members who are responsible for addressing and investigating reports of harassment, intimidation, or bullying.
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The hib initial referral2014 revised is a form used to refer a student for initial evaluation for eligibility for special education services.
The student's parent or legal guardian, a teacher, or a school administrator may be required to file the hib initial referral2014 revised form.
The hib initial referral2014 revised form should be filled out with the student's information, reason for referral, and any relevant documentation supporting the need for evaluation.
The purpose of hib initial referral2014 revised is to initiate the process of evaluating a student for eligibility for special education services.
The hib initial referral2014 revised form should include the student's name, date of birth, current grade level, reason for referral, and any relevant background information.
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