Advocacy & Support

Student Concerns Form

Use below form to report a concern or complaint
NOTE: This form is only monitored during regular business hours and if this is an emergency please call police.

Contact Information

Full Name :

Student ID#:

E-Mail:

Phone number:

Best time to reach you:

Have you ever contacted a USF Dean?:

If Yes, then please enter the name of the dean you contacted:



PLEASE CHECK ALL RESPONSES THAT APPLY

Academic:

Withdrawal
Problem with a faculty \ staff \ student


Class Absence(s):

Need excuse for university approved activity
Need excuse for funeral attendance
Personal issue
    Other :


Unique Problem:

Harassment related issue
Student Organization related issue
Discrimination related issue


Miscellaneous :

Prior Conduct Review
Recommendation letter
Re-admission advice
Graduate / Professional reference


Who referred you to the Dean for Students?:

Self referral
USF web page
USF publication
Friend
Another student
Student Leadership
    Administrator or faculty member - provide name :     Other - list source :


Visit Details

Please provide a brief description of the problem. Specifically, if you are reporting a problem with a class or instructor, if you need a class excuse for a unique reason, or if you have a unique problem, then please provide pertinent details of the issue you are reporting:


Please select YES if all entries stated above are correct: