Today's Choice for Tomorrow's Future

Reporting Bullying or Harassment

The Choice and Alternative Education Department has developed a bullying complaint form for individuals to report bullying incidents. An individual can complete a form giving the name of the person reporting the incident or the incident can be reported anonymously.

If you have information regarding a bullying or harassment act as defined in Policy 5517.01 and Florida Statute 1006.147, please fill out one of the two forms below to the best of your knowledge and submit to your school. To review Policy 5517.01, go to the website page titled "Bullying or Harassment Law and Policy" in this section.

The following factors will determine if bullying or harassment for students and employees falls within the scope of the Lake County School District:

A. During any education program or activity conducted by the District; or
B. During any school-related or school-sponsored program or activity or on a District school bus or at a District school bus stop; or
C. Through the use of data or computer software that is accessed through a computer, computer system, or computer network of the District within the scope of the school district, meaning regardless of ownership, any computer, computer system, or computer network that is physically located on school property or at a school-related or school-sponsored program or activity; or
D. Through the use of data or computer software that is accessed at a non-school-related location, activity, function, or program or through the use of technology or an electronic device that is not owned, leased, or used by the District or school, if the bullying substantially interferes with or limits the victim’s ability to participate in or benefit from the services, activities, or opportunities offered by the District or school or substantially disrupts the education process or orderly operation of a school. This paragraph does not require a school to staff or monitor any non-school-related activity, function, or program.


If you are the victim of Bullying or Harassment, below are some steps you can take.

  • Clearly tell the bully(ies)harasser(s) to stop.
  • Don't ignore the incident. Immediately report the incident to someone at school.
  • Tell your parent(s)/guardian(s).
  • If the bullying/harassing continues after you have clearly told the bully(ies)/harasser(s) to stop, make a written record of the incident including date, time, witness or witnesses, and parties involved in the incident.
  • Report the incident immediately to an adult who has authority over the bully(ies)/harasser(s); for example, teacher, certified school counselor, assistant principal, or principal.
  • Avoid being alone with the person(s) who has attempted to bully/harass.

To minimize the risk of being accused of bullying or harassment, below are some "Do" and "Don't" steps to note.


  • Keep your hands to yourself.
  • Remember that NO one has a right to harm another person in any way.
  • Think before you speak.
  • Immediately apologize if you accidentally say or do something that has made another person feel oppressed.
  • Report all incidents of bullying/harassing behavior you have witnessed to appropriate school personnel.


  • Touch anyone without his or her permission and especially in an inappropriate way.
  • Keep interacting with a person after he or she has perceived your behavior toward him or her as being inappropriate and has clearly told you to stop.
  • Make remarks that may cause another person to feel oppresses (stressed, scared, intimidated).


  • Verbally to an adult at school.
  • On a Bullying or Harassment Reporting Form located at a student's school.
  • Using the reporting form below.
  • Use the SpeakOut Hotline in one of three ways:
If you fear a student is in immediate danger, please contact the student's school RESOURCE OFFICER or police immediately! 

Directions for Use of Forms:

  1. Click on the form of choice below.

  2. Print the form.

  3. Fill in the form.

  4. Drop the form off at the designated location in your school.