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Block Island School Student/Community Concern Form

Please complete the form below. Required fields marked *

Please fill out this form when becoming aware of, or hearing and/or seeing a threat. Once the form is completed it will be electronically forwarded to Block Island School Administration. An immediate evaluation of the situation will take place to determine further action.

 

WHEN IN DOUBT, FILL IT OUT!

Person Reporting the Incident

Contact Information
Check all that apply
Answer Required

People Involved

When did the incident take place?

Where did the incident take place?

Check all that apply?*
Answer Required

Select the statements(s) that best describe the incident

Choose as many as applicable*
Answer Required

Note:  A threat is an expression of intent to harm self, others, property, pets, etc. Threats may be spoken, written, or gestured.  An expression of intent to harm is considered a threat regardless of whether it is communicated to an actual or prospective victim.