The Dean of Students Office

Creating a Culture of Care

Share A Concern

COVID-19 Incident Complaint Form

This form is used to report information to the Office of Student Rights and Responsibilities which may constitute violations of the University’s COVID-19 policy including but no limited to concerns regarding face coverings, social distancing, hosting or attending large gatherings, unauthorized visitors, failure to quarantine/isolate and behavior of visitors on campus.

Concerning Behavior Form

Community members are encouraged to use the Concerning Behavior Form if they are concerned about the behavior of a student, faculty or staff member. Please review this link for more information before submitting the form.

If this is an emergency that requires immediate attention, please contact campus police at 336.334.4444 prior to filling out this referral form. While referrals from this form are reviewed by UNCG PD, it is not designed as an emergency response notification process.

Interpersonal Violence Reporting Form

This form should be used by any person to report an incident involving an alleged violation of the UNCG Policy on Sexual and Gender- Based Harassment, Sex Discrimination, and Other Forms of Interpersonal Violence (sexual harassment, sexual assault, gender-based harassment, intimate partner violence, domestic violence, and stalking). This report form can be utilized by students, faculty, or staff wishing to file a report on their own behalf or by anyone wishing to file a report on behalf of any aggrieved person.

Incident Reporting Form

The Incident Report Form is available to any person who wishes to report a suspected violation of the Student Code of Conduct. Faculty wishing to report a suspected Academic Integrity violation should not use this form. Instead, please use the Academic Integrity Referral Form.

Student Assistance Fund for Emergencies (SAFE)

The Student Assistance Fund for Emergencies (SAFE Fund) has been created for the purpose of providing quick response emergency funds to matriculating students with short-term unexpected financial emergencies. While this is not a complete list, SAFE funds may be used for temporary housing, transportation, food, unforeseen medical expenses, safety needs, or essential academic expenses such as textbooks, classroom or lab equipment, or educational supplies. The SAFE Fund is not designed to cover tuition and fees on a student’s University account. Relief funds also do not have to be repaid.

Applicants must complete the SAFE Fund application in its entirety and submit supporting documentation, where appropriate and possible. Applications that are not complete and do not have a student ID number provided will not be processed. You may also be asked to contact the Dean of Students Office to discuss the appropriate documentation for your situation.

Before completing the form, applicants are encouraged to review all information, including eligibility requirements, award amounts, and disbursement of funds, located at UNCG Student Emergency Fund Information.

By submitting this form, you certify that the information you have provided is accurate and complete. You will notify the Dean of Students Office in writing immediately if, after submission of this application, there is any change in the information provided. You understand that falsifying or withholding information in this application may result in a violation of the Student Code of Conduct.

Medical Documentation Review Form

This form should be used by current students to submit recent (within the last 30 days) medical documentation to the Dean of Students Office. The Dean of Students Office can review documentation due to documented medical circumstances, including medical emergencies, hospitalizations, or other medical/mental health situations. Please make sure you have reviewed the Dean of Students Office website for more detailed information regarding the specific circumstances the office will review. Submitting this form will initiate the documentation review process. If you have specific questions regarding documentation review, please contact the Dean of Students Office at 336.334.5514 during regular business hours (Monday through Friday, 8 a.m. to 5 p.m.). If you have an emergency, please contact the UNCG Police Department at 336.334.4444.

Academic Integrity Referral

This form is designed for faculty who seek to refer a suspected academic integrity violation to the Office of Student Rights and Responsibilities. Only the faculty member overseeing the academic exercise in question may refer an academic integrity case. Students who wish to report a suspected academic integrity violation should contact the faculty member of the course or academic exercise in which the violation allegedly occurred. Click here to view the Academic Integrity Policy.

Notice of Appeal Form

Students or student organizations may use this form to submit an appeal to their Student Conduct or Academic Integrity case. All students or student organizations interested in filing an appeal must complete the form in its entirety. Please note students/student organizations will need the case number associated with the appeal when submitting this request. The case number can be found on your outcome letter that was delivered detailing the decision and any imposed sanctions. Appeals must be submitted within three (3) business days of the decision letter. The appeal must clearly state the grounds on which it is based and present specific reasons or justifications to support the appeal. For more detailed information on appeals, please click here.

OARS Grievance Procedures

UNCG adheres to the grievance procedures set out here for the prompt and equitable resolution of complaints by students with disabilities alleging a violation of their rights under Title II of the Americans with Disabilities Act of 1990 (Title II) and Section 504 of the Rehabilitation Act of 1973 (Section 504). Title II and Section 504 are intended to prevent discrimination on the basis of disability. Questions regarding these procedures and or the reporting form should be directed to the Office of Accessibility Resources and Services, 215 Elliott University Center, telephone 336.334.5440.

The Formal Grievance form may be obtained online by clicking here.