Report dangerous weapon incidents and active shooter incidents in schoolzones

Report dangerous weapon incidents and active shooter incidents in school zones
Use this form to report incidents to the Minnesota Department of Education and the Minnesota Fusion Center.
Describe the incident or threat*
Incident date*

MonthDayYear
MM-DD-YYYY
Name of the impacted school facility*
Type of school facility impacted
Highest grade taught at impacted facility
Suspected victim of incident or threat*

School personnel (in general)Students (in general)Specific studentSpecific school personnelSchool/facilityPublic gatheringSpecial eventOther
Location of reported incident or threat*

On school propertyOff school propertyIn a school zone
How the threat or incident was reported to the school

Anonymous reporting systemStudentParentSchool staff memberLaw enforcementCommunity memberOther
How the incident or threat was communicated by the person who carried out the threat or incident*

Phone callText messageEmailIn-personSocial mediaWrittenOther
Nature of incident or threat received*

ArsonFirearmEdged weaponExplosive/Improvised explosive deviceVehicle rammingChemical/biological/radiologicalPhysical violenceOther
Validity of incident or threat

Threat confirmed (dangerous item located, person identified)Threat confirmed (not credible, no means to carry out threat, person identified)Threat unconfirmed (no dangerous item located, person not identified)Threat disprovedSwatting (A malicious hoax call to emergency services to falsely report an ongoing emergency such as a violent crime or explosive device at a certain location.)Hoax threat (A threat designed to disrupt, distract or harass locations or organizations.)
Outcome of incident or threat

Attack occurredAttack avertedNo attackAttack interrupted
What is the age of the person involved?*
Is the person a student?*

YesNo
Name of school currently attending*
What grade are they in*
Was the student under active suspension or expulsion at the time of the incident?*

YesNo
Connection or association

Former studentFormer personnelSchool personnelPerson unaffiliated with schoolIs the person a studentParent or relative
Immediate cost of the incident to the school or district (select all that apply)*

Medical and healthcare costs (for example, emergency medical services or mental health support)Property and infrastructure damageBusiness interruption and operational costs (for example, classroom time or staffing hours)Transportation costsUnknownOther
Actions taken by school administration to respond
Change in school posture (select all that apply)*

LockdownHoldSecureShelterEvacuateLate/Delayed startEarly dismissalLate dismissalTransition to e-learning/Distant learningOther
Actions taken if incident or threat is from an enrolled student*

Student expelledStudent suspendedStudent withdrawalReferral to mental health servicesSchool personnel dismissed, firedNot a student or school personnelOther
If not a student or school personnel, describe relationship to school and actions taken*
Threat assessment process (select all that apply)*

StartedNot startedInvolves law enforcementDoes not involve law enforcementWe do not have a threat assessment process
Which law enforcement agency has jurisdiction over the school?*
Are there other law enforcement agencies with jurisdiction over the school?*

YesNo
List other law enforcement agencies with jurisdiction over the school
Was the incident or threat reported to law enforcement?*

YesNo
Which agency?
Case number
Was there a response from emergency services (ambulance, fire, law enforcement, etc.)?*

YesNo
Responding emergency services (select all that apply)*

Law enforcementFireEMSOther
If you selected “Other” for any of the above questions or would like to expand upon any of the previous responses, please do so here.
Point of contact for follow up, as needed.
Name*

First NameLast Name
Email*
example@example.com
Phone number*
Format: (000) 000-0000.
Position/title/role*
Please verify that you are human*
Should be Empty:

Report dangerous weapon incidents and active shooter incidents in school zones

Actions taken by school administration to respond

Point of contact for follow up, as needed.