Who are you writing to? Who can you trust?

How long has this been going on?

• being bullied
• being cyberbullied
• bullying someone
• worried about my safety
• worried about a friend
• Other

Describe the situation. You don’t have to give a lot of detail if you don’t want to.

Are there a couple of words that describe what you're going through? Are you angry? Upset? Scared? Confused?

• Talk about it
• Tell someone who can make it stop
• Find a counsellor
• Avoid the person I’m afraid of
• Get help for my problem

Is there anything else you’d like to tell this person? Are there any more details that you think this person should know?

• Include this line
• Don't include this line

Type your name.