Teacher Incident Report

Date

Class Title

First Name

Last Name

Email (Required if you would like the Hugo House staff to follow up with you)

What happened? Please include which part(s) of the Student Guidelines were violated.

Did you address the situation in class and/or privately with the student(s) in question?

If another student was harmed, have you spoken with them? If so, how did that go? Do they have demands or requests of you or Hugo House? Are there reparations that should happen?

Would it be safe, in your opinion, for the harming student(s) to continue in your class and/or register for another class at Hugo House? Are there actions that the student can take to participate safely in the future?

Teacher Incident Report

Physical Location

Mailing Location