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#:


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:



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
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: