Incidents, Concerns, & Complaints Reporting

This page is not for reporting emergency situations. If you or the person you are reporting on is in immediate danger of harming themselves or others, please call 911 immediately!

This page is to help students, faculty, staff, and community members locate Burrell resources and guidance to resolve concerns, report incidents, and make requests.

Accordion Content
(Students, Faculty, Staff, or Guests) This form is to be completed within 24 hours of the incident and returned to the Compliance Office. In the event of an employee injury/illness, an additional Notice of Accident form is required to be filled out.

(Students, Faculty, Staff, or Guests)

The Burrell College of Osteopathic Medicine has established standards to foster a safe and equitable environment conducive to learning and development. The College shall maintain and publish those procedures necessary for the filing of any grievance by any person or organization regarding the conduct of the College’s programs or operations or regarding the conduct of its students, faculty or staff. The College shall provide a means whereby such filings may be made anonymously.

The College grievance form is routed to the Office of Compliance. Please read the Grievance Policy for information on procedures.

(Students, Faculty, Staff, or Guests)

Any individual who believes Burrell College of Osteopathic Medicine is not in compliance with a Commission on Osteopathic College Accreditation (COCA) standard has a right to address his/her concern. The complaint will be kept on file in a confidential manner. Please see Accreditation Standard Complaint Policy B2030 (Policy B2030) regarding the process for filing a complaint.

Title IX Sexual Harassment/Sexual Discrimination Request for Investigation

(Students, Faculty, Staff, or Guests)

This form may be completed by any member of the Burrell community who has experienced or otherwise become aware of an incident that may constitute a violation of the Title IX: Sex Discrimination and Harassment Policy. Please complete the form to the best of your ability.

Title IX


Title IX Mandatory Reporting Form

(Students, Faculty, Staff, or Guests)

Individuals designated as Officials with Authority (OWA) or Mandatory Reporters by Burrell College must complete this form upon receiving notice of an alleged violation of Title IX: Sex Discrimination and Harassment Policy and submit it to the Burrell Office of Compliance upon completion.

Title IX


A Campus Assessment Response & Education (CARE) Team is a multidisciplinary team whose purpose is to support students in matters related to wellness and mental health. The Burrell College CARE Team provides early intervention, performs at-risk assessments, offers behavioral intervention recommendations/guidance, referrals to outside resources, coordinates follow-up, and attends/provides related training opportunities for faculty and staff.


The purpose of this form is to enable you to share comments or suggestions with members of your SGA. We realize that it is sometimes difficult to express comments or suggestions and we were hoping that offering the option of an anonymous online form would assist. This form is not intended for venting, but to share legitimate requests, comments, or suggestions. We will ensure that each request/comment/suggestion is addressed and will follow up with appropriate persons by a personal e-mail if available. If the information concerns the entire student body, information will be sent through the weekly e-mail updates.


More about Grade Review requests can be found in the Student Handbook – Chapter 25. Course Grades.

(Students, Faculty, or Staff)

Additional forms can be found on the following pages.

Research Forms can be found on the specific Committees’ page.