Anonymous Incident Reporting Form
This form allows any Chester Academy students, staff, and/or family members to anonymously report concerns to CA Administration.  

As a school community, we encourage all members to "See Something, Say Something."  When possible, incidents should be reported to trusted adults, including school administrators, as early as possible.  This form is intended to be used when the reporter wishes to remain anonymous.  Parents and guardians should continue to communicate with us via email or phone.

Please note - we will do our best to investigate and respond to anonymous reports, however it can often be difficult to complete thorough investigations or to close the communication loop when something is reported anonymously.  
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Please describe what happened.  Helpful details include what happened, where it happened, what was said/done, names (first & last, when possible) of those involved, etc.
When did this happen?
MM
/
DD
/
YYYY
Where did this happen?
Is there anyone who witnessed, or may have witnessed, the incident?  If so, please list names (first & last, when possible).
Your name (optional - allows us to follow up with you)
Your email (optional)
Can we contact you to ask further questions about this incident?
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Is there anything else you would like us to know?  Use this space:
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