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Home » Student Support » Staff Informal Complaint Form

Informal Complaint Form

To be completed by a UIU faculty of staff member on behalf of a UIU student.

The student complaint procedures are established to address concerns that arise within the University community. A complaint is a concern regarding a policy or procedure that has been inappropriately or unjustly applied or a charge against an individual’s behavior. If you have addressed a student complaint, please report it using the form below.

All questions require answers

UIU Campus/Center/Location:

Faculty/Staff First Name:

Faculty/Staff Last Name:

Faculty/Staff Phone Number:

Faculty/Staff E-mail address:

Faculty/Staff Verify your e-mail address:

Department Involved:

Student First Name:

Student Last Name:

Student UIU ID Number:

Nature of Complaint (please check one):

Behavior
Policy
Procedure

Date of Occurrence:

Person(s) Involved:

Briefly describe the event or circumstances and how the concern was addressed: Describe the event or circumstances

Upper Iowa University
605 Washington Street | P.O. Box 1857
Fayette, Iowa 52142 | 800.553.4150