Incident Report

We take the safety and security of our school and students very seriously. We do not accept anonymous reports, however we will maintain confidentiality to the degree permitted by law and our investigative effort. Note that false reports will be handed over to the Boone County Sheriff's Office for further investigation.

Name(s) of Victim: REQUIRED Please fill out this field. Please enter valid data.

Name(s) of Perpetrator(s) REQUIRED Please fill out this field. Please enter valid data.

Name(s) of Witnesses: REQUIRED Please fill out this field. Please enter valid data.

Describe What Happened (date/time/location etc) REQUIRED Please fill out this field.

What Evidence Is There? REQUIRED None Notes/Writings Recordings Pictures Medical Report Other Please fill out this field.

The above information is true to the best of my knowledge and belief, and I understand that this report may be used as a part of a formal investigation. False reports are provided to the Boone County Sheriff's Office for investigation.

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Email REQUIRED Please fill out this field. Please enter an email address.

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Immaculate Heart of Mary
Catholic School

Burlington, Kentucky

Incident Report