Victoria Independent School District

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Employee Incident Reporting Form

This form is for employees to report incidents including, but not limited to, bullying, discrimination, sexual harassment, dating violence, and threats.

Victoria ISD has a strong policy regarding employee welfare and crisis intervention. If you have experienced a harmful, threatening, or violent situation while at work please complete the form below or talk with your immediate supervisor.

Should you need counseling resources because you were a victim or witness to a threat, please contact the SupportLinc Employee Assistance Program at 1-800-475-3EAP (3327) or www.supportlinc.com, username: victoriaisd

Incident Information:

Name(s) of witness(es) to incident:

Has anyone helped you with this complaint?*
Answer Required
Is this the first incident?*
Answer Required

Agreement

I certify that all statements made on this form are true, correct, and complete. Any intentional misstatement of fact will subject me to appropriate discipline. I authorize school officials to disclose the information I provide only as necessary to pursue the investigation.

Confirmation Email