Dignity for All Students Act (DASA) Incident Reporting Form

This form will route the school of the person reported as a target. The school administration will investigate this report.  
To be completed by person reporting the incident (or the person receiving the complaint and/or investigating the incident):
Role of person reporting incident: *
What was your involvement in the incident? *
Where did the incident happen? (Check all that apply) *
Type of incident (Check all that apply) *
Who was involved in the incident? *
Types of bias involved (if known): (Check all that apply) *
Was the student absent from school as a result of the incident? *
Does the situation continue to occur? *