Inappropriate Behavior Report Form

AY 2019-20

This web form is free-standing, and is not connected to the course evaluation form (if you arrived here via the link on its end page). Your identity is completely anonymous unless you choose to identify yourself.

In which college are you in?

If your are dual-enrolled, mark the college of the course in which the issue happened.

In what course did you have an issue?
What was the nature of the inappropriate behavior?
Please elaborate:
Would you like to speak to someone about this?

 It is suggested that you contact Dr. Sandra Emerick in the Office of Student Affairs.

Your name, if you choose to give it:

When you click Submit Survey, the contents of this form will be sent to the upper leadership in your college and to the Chief Student Affairs Officer.

Northeast Ohio Medical University (NEOMED)