The best way to prevent bullying is to report it when it occurs. This form offers students and parents the opportunity to do that in a confidential manner. Each reported incident of bullying will be taken seriously and investigated.

If you have any questions or concerns, do not hesitate to contact the Elementary School DASA Coordinator:

John Bresnock, K-5 school counselor
(716) 876-7505, ext. 2215
email: jbresnock@csat-k12.org

	First and Last Name (optional):

	Email Address (optional):

	Phone Number (optional):

	Please describe the incident of bullying in as much detail as possible.*

CSAT Bullying Report -- K-5