Mode: In Person Phone Text Email Letter Social Media Internet Other Multiple Target(s) injured: Yes No Unknown Target(s) require medical attention? Yes No Unknown Weapon involved: Yes No Unknown Type of Weapon: Firearm[Rifle/Shotgun Pistol] Edged Bomb Other: Details of the incident or threat. Where threats were communicated, quote where possible, use quotation marks to indicated direct quotes. Attach original communications if available. PART II. PERSONS INVOLVED SUBJECT (1) Engaging in threatening, aberrant or concerning behavior: Name: Unknown ID #: Current Former Prospective Affiliation: Status: Administrator Teacher Staff Student Parent/Guardian Grade:_______________(if student) Contractor Other:_______________________________ None/Unknown School: Emergency Relationship: Contact Home Phone: Address: SUBJECT (2) Engaging in threatening, aberrant or concerning behavior: Name: Unknown ID #: Affiliation: Status: Current Former Prospective Administrator Teacher Student Parent/Guardian student) Contractor Other:_______________________________ None/Unknown School: Emergency Relationship: Contact
Mode: In Person Phone Text Email Letter Social Media Internet Other Multiple Target(s) injured: Yes No Unknown Target(s) require medical attention? Yes No Unknown Weapon involved: Yes No Unknown Type of Weapon: Firearm[Rifle/Shotgun Pistol] Edged Bomb Other: Details of the incident or threat. Where threats were communicated, quote where possible, use quotation marks to indicated direct quotes. Attach original communications if available. PART II. PERSONS INVOLVED SUBJECT (1) Engaging in threatening, aberrant or concerning behavior: Name: Unknown ID #: Affiliation: Administrator Teacher Staff Student Parent/Guardian Contractor Other:_______________________________ None/Unknown Status: Current Former Prospective Grade:_______________(if student) School: Emergency Contact Relationship: Home Address: Phone: SUBJECT (2) Engaging in threatening, aberrant or concerning behavior: Name: Unknown ID #: Affiliation: Administrator Teacher Student Parent/Guardian Contractor Other:_______________________________ None/Unknown Status: Current Former Prospective student) School: Emergency Contact Relationship:
threat-assessment-model-policies-procedures-and-guidelinesdocx.docx