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Grimmer Middle School BULLYING or HARASSMENT REFERRAL FORM Name: Grade: Names of student(s) bullying: Today s Date: Names of witnesses/Bystanders: 1. Date and approximate time the bullying occurred
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How to fill out bullying or harassment referral

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How to fill out a bullying or harassment referral:

01
Begin by gathering all necessary information regarding the incident. This may include the date, time, and location of the incident, the names of those involved, any witnesses, and a detailed description of what occurred.
02
Ensure that you have a copy of any relevant documents or evidence, such as emails, messages, or photos, to support your referral.
03
Use a clear and concise language to describe the incident, focusing on the specific behaviors that were observed or experienced. Avoid speculation or making assumptions.
04
Provide any additional information that may be relevant, such as previous incidents, any actions taken to address the situation, or any attempts to resolve the matter informally.
05
Include your contact information and details so that the appropriate authorities can follow up with you if necessary.
06
Submit the referral through the designated channel or to the appropriate person or department, as determined by your organization's policies and procedures.

Who needs a bullying or harassment referral?

01
Any individual who has experienced or witnessed bullying or harassment behavior within an organization or community may need to submit a referral.
02
This can include employees, students, parents, or volunteers who have been affected by such behavior.
03
It is important to remember that reporting bullying or harassment is not limited to the victim, but also extends to those who have observed the behavior and feel compelled to take action.
04
Some organizations may also have a duty to report incidents, such as schools or workplaces, where it is their responsibility to ensure a safe environment for all individuals.
Remember, it is essential to consult your organization's policies and procedures for specific guidelines on how to fill out a bullying or harassment referral.
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Bullying or harassment referral is the process of reporting incidents of bullying or harassment in a formal manner to authorities or designated personnel.
Any individual who witnesses or experiences bullying or harassment is required to file a bullying or harassment referral.
Bullying or harassment referral can be filled out by providing detailed information about the incident, including dates, times, locations, and individuals involved.
The purpose of bullying or harassment referral is to document and address instances of bullying or harassment to ensure a safe and respectful environment.
Information such as the date, time, location, description of the incident, names of individuals involved, and any witnesses must be reported on a bullying or harassment referral.
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