The School District of Martin County
500 East Ocean Boulevard
Stuart, Florida 34994

Phone: 772-219-1200
Extension:
Toll Free Phone:
Fax:
TDD Phone:

Website: www.martinschools.org

Program Description

Complete this report to document incidents of alleged bullying and harassment in accordance with School Board Policy 5517.01 Anti-Bullying and Harassment. Submit this report to the school Principal/designee. ‣If you suspect IMMEDIATE danger exists, please contact law enforcement

Services Available Through This Program

Abuse Prevention- Child

Hours of Operation

Eligibility Requirements and Important Information

If more than one person is alleged, complete separate form for each.

Availability and Fees

Current Wait List:	NO
Handicapped Access:	NO
Accepts Medicaid:	NO
Accepts Medicare:	NO
Accepts Private Insurance:	NO
Financial Assistance Available?:	NO
Sliding Scale:	NO

Other Fee Information

No fee

Other Useful Information

Description of Alleged Incident: Be specific and describe exactly what happened and/or state what information was reported to you. Include name, school, relationship to parties, prior incidents of any kind between any persons named in the incident, location (eg., hallway, locker room, class, building, at home, in school activity, extra-curricular, recess) and any other factors that may have contributed to the situation or might be making the situation worse.