Bullying Report Form for Employees

"*" indicates required fields

Reporting bullying at work

Kentucky Wesleyan is committed to providing a respectful and inclusive environment for all employees. As such, bullying behaviors will not be tolerated. Bullying is repeated, unwanted intimidating or aggressive behavior that is intended to cause harm, fear, or distress and that involves a real or perceived power imbalance. It is often used to exert dominance or control over another person. Bullying behaviors can range from subtle to overt and can take verbal, written, physical, or electronic forms. Cyberbullying is a form of bullying that is carried out through electronic communication methods, such as email, texts, or social media.

Employee Name*

First Last

Employee Job Title*

I am reporting bullying that:*

I experienced myself.

I observed someone else experience.

Name of the employee that was bullied.*

Name of the employee that did the bullying.*

Description of the events.*

Please be as specific as possible (e.g., dates, locations, witnesses, wording, etc.).