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The UTRGV School of Medicine
Professionalism Portal
Student Reporting Form


The University of Texas Rio Grande Valley School of Medicine seeks to provide fair and objective procedures for hearing student non-academic complaints and endorses compliance with the spirit of non-discrimination regulations. If a student is not able to resolve an issue or complaint with an individual or department involved, then please submit a Vaqueros Care Grievance Report It Form. Incidents reported through this form will be investigated at the discretion of The School of Medicine. Note: Some features of this form require a Flash enabled computer.

Reporters Information

Reports may be submitted anonymously. Only those areas that are marked with an asterisk are required to complete the form.

 
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Involved Parties

Please identify all parties associated with this complaint. To add the name of witnesses or others involved click the box below to add to this report.

Involved party 1

Questions

Please complete all of the sections below:

The subject of this report named above is a:(Required)
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Who is affiliated with the:(Required)
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Professionalism Concerns Please check the item(s) that best describe(s) the individual's behavior about which you are concerned:(Required)
You must make at least one selection.
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Do you want us to investigate this incident or do you want us to just be aware of the incident?(Required)
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May we contact you?(Required)
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Supporting Documentation

Photos, video, email, and other supporting documents may be attached below. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Submission