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* We welcome any information you have about:
* The use of a “safe room”, “quiet room”, or “time out room” in a school;
* The practice of physically restraining students in your community school; or,
* Students who have been affected by the use of restraint and/or seclusion at school.

This form will let you contact us anonymously. The more information you can share, the more useful it will be. If you can, share:
* The name of the school;
* The name of the person with the disability, if known;
* Grade level or age of the child, if known;
* The date (or general timeframe) of the concern.

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* Anything else you would like us to know?

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