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WashingtonStateHarassment,IntimidationorBullying(HIB)
IncidentReportingForm
Reportingperson(optional):___
Targetedstudent:___
Youremailaddress(optional):___
Yourphonenumber(optional):___Todaysdate:___
Nameofschooladultyouvealreadycontacted(ifany):___
Name(s)ofbullies(ifknown):
___
Onwhatdatesdidtheincident(s)happen(ifknown):
___
Wheredidtheincidenthappen?Circleallthatapply
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