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ESSER III
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Threat Assessment Form
Threat Assessment Form
Date of Threat
*
Answer required for "Date of Threat"
Person completing form
*
Answer required for "Person completing form"
Staff/Non-staff
*
Email
Answer required for "Staff/Non-staff"
Invalid email address
Phone number
*
Number Required
Invalid phone number
Time of Report
*
Answer required for "Time of Report"
Campus Location
*
(Ex. Prichard, Scyene, Cedar Hill)
Answer required for "Campus Location"
Type of Threat
*
Answer required for "Type of Threat"
Bomb Threat
Personal Injury
Burglary
Computer Cyber Crime
Fire / Fire Alarm
Vandalism
Other:
Who has been notified?
Answer required for "Who has been notified?"
Police
Fire Department
Parent / Guardian
School Personnel
Who was involved?
Status
*
Answer required for "Status"
Student
Employee
Visitor
Unknown
Person 1 name
*
Answer required for "Person 1 name"
Person 1 Contact Information
*
Answer required for "Person 1 Contact Information"
Person 2 name
Answer required for "Person 2 name"
Person 2 Contact Information
Answer required for "Person 2 Contact Information"
Describe the threat
*
(What was said or demands)
Answer required for "Describe the threat"
Confirmation Email
Confirmation Email
Answer required for "Confirmation Email"
Invalid email address
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