School Bullying Incident Log (Free PDF)

Track bullying incidents with dates, locations, witnesses, and school responses so you can share a clear record with administrators or a lawyer.

Student & School Details

Add the basics so administrators or advocates know who to contact.

Student name

Grade

School name

School district

Parent / Guardian

Contact email

Contact phone

Record each bullying incident with what happened and how the school responded.

Add each incident below. Include online or in-person events.

Incident date

Incident time

Location

Description

Bully names (if known)

Witnesses

Reported to

Report date

School response

Impact on student

Add overall concerns or patterns you want to highlight.

Overall concerns