COVID-19 Complaint

COVID-19 Complaint Form

This form is to be used specifically for complaints regarding COVID-19.

Please fill out the form below to get started.

Your First Name

Your Last Name

Your Student / Employee ID

Your Student / Employee Email Address

Ex. jdoe6@student.umpqua.edu or john.doe@umpqua.edu

Your Phone Number

Cell phone is best

Describe complaint.

Please use as much detail as possible. Include times, locations, and any names known of all involved.

Have you attempted to resolve your concern? If so, how?

What outcome or resolution are you seeking?

Preferred Method of Contact

If "Do Not Contact" selected, form will be handled anonymously.

If other, explain: