LDSB Student Human Rights Incidents and Complaints / School Safety Reporting Form

This form is not a crisis response tool. If this is an emergency, please call 9-1-1.

If this is a mental health crisis, you can:

Call the Addictions and Mental Health Crisis Line at:

613.544.4229 or 1.866.616.6005 in Kingston & Frontenac
613.354.7388 or 1.800.267.7877 in Napanee and Lennox & Addington

Call the Sexual Assault Centre Kingston's Crisis Line at 1.877.544.6424
Call Kids Help Phone at 1.800.668.6868 or text CONNECT to 686868 or chat online at https://kidshelpphone.ca/urgent-help
For Indigenous mental health supports, call Hope for Wellness Helpline 1.855.242.3310 (service available in English, French, Ojibway (Anishinaabemowin), and Inuktitut).

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If you want this form in an alternative format or if you want help to fill out this form, please contact Yusuf Abdulkareem, Human Rights and Equity Advisor at abdulkareemy@limestone.on.ca or by phone at 613.544.6920 extension 31256.

The Limestone District School Board is committed to an equitable and inclusive school climate that ensures all students, staff, and members of the broader school community feel safe, comfortable, and accepted.

Students, families, and staff are encouraged to report incidents as soon as they happen.

Use this form to report:

Human Rights complaint: Use this form to report an incident of discrimination or harassment based on the protected grounds in the Ontario Human Rights Code that involves a Limestone student or students. You can also use this form to report hate activity in the school community.
Bullying/or Cyberbullying: Bullying is aggressive behaviour that is typically repeated over time. It is meant to cause harm, fear, or distress or create a negative environment at school for another person. Bullying or cyberbullying occurs in a situation where there is a real or perceived power imbalance.
School safety: School safety issues are those which might result in a crime, violent incident or environmental concern.

Please provide as much detail as possible, including dates and locations of incidents. This form will be sent to the principal and vice principals of the school where the incident happened. If this report is about a principal or vice principal, it will be sent to their supervising superintendent. If it is about a superintendent, it will be sent to the Director of Education. All reports are also sent to the Human Rights and Equity Advisor and the Associate Superintendent of Curriculum & Program Services: School Climate & Community Engagement .

You can report an incident anonymously. Please note that if you do not provide contact information, we cannot contact you to follow up.

If you have provided your contact information, you can usually expect contact within 48 hours, except on weekends or holidays.

Reported incidents are tracked and monitored by the board to ensure accountability and transparency. Individuals will not be identified where it would violate privacy or personal safety. Information in this form is collected in accordance with the Municipal Freedom of Information and Protection of Privacy Act (MFIPPA) and is authorized by the Education Act (1990, S. 169.1).

Full Privacy Statement Student Human Rights and Safe Schools

Type of incident

Human Rights complaint: An incident of discrimination or harassment based on the protected grounds in the Ontario Human Rights Code that involves a Limestone student or students. You can also use this form to report hate activity in the school community.
Bullying/or Cyberbullying: Bullying is aggressive behaviour that is typically repeated over time. It is meant to cause harm, fear, or distress or create a negative environment at school for another person. Bullying or cyberbullying occurs in a situation where there is a real or perceived power imbalance.
School safety: School safety issues are those which might result in a crime, violent incident or environmental concern.

What type of incident are you reporting? *

If you want us to contact you, please enter your information here.

This is optional

Your name

Your pronouns (e.g. he, she, they)

Your phone number

Your email address

Your role

What is your role? *

I'm filling out this form... *

On behalf of a student

Is the student aware you are filing this complaint?

Yes

No

The student's name

The student's pronouns (e.g. he, she, they)

Your relationship to the student

Sometimes these reports raise important issues about safety. If a student's safety is at risk, we may need to contact parents, guardians or caregivers.

Will the student agree to our contacting parent(s), guardian(s), or caregiver(s) about this complaint?

Yes

No

Not applicable

I don't know

Is there anything else we should know in case we need to contact a parent, guardian or caregiver?

Is there anything we should know to best support this student during our investigation?

What grade is the student in?

Student / self submission

Sometimes human rights complaints raise important issues about safety. If a student's safety is at risk, we may need to contact parents, guardians or caregivers.

Can we tell your parent(s), guardian(s), or caregiver(s) about this complaint?

Yes

No

Not applicable

Is there anything else we should know in case we need to contact a parent, guardian or caregiver?

Is there anything you would like us to know about you to help us support you during the investigation?

What are grade you in?

Who is the respondent?

Who is your complaint about?

Select all that apply.

Principal

Vice Principal

Superintendent

LDSB Staff Member

Parent/Caregiver/Guardian

Student(s)

None of the above

Enter their name(s) and grade(s) (if applicable)

This is optional

Where / when did this happen

At what school did this happen? *

Is your complaint about an ongoing problem? "Ongoing" means it has happened more than once and has been happening for a while

Yes

No

I'm not sure

Please enter the date of the incident, if you know it

Have you made a complaint about this incident before?

Yes

No

Description of incident

Please describe the incident(s) or issue(s). Please give as many details as possible like: Where did it happen? Who was there? What did they do? How did you feel when it happened? *

If you have any evidence that you want us to consider, you can upload it here. You can upload photos, videos or documents.

Evidence Files

This is the end of the form. If you would like to make changes, use the back button. If you are ready to submit click Submit Form.