Resident/Student Mistreatment Reporting Form

Mistreatment, as defined in the Penn State College of Medicine Student Handbook, arises when behavior shows disrespect for the dignity of others and unreasonably interferes with the learning process. This could include behaviors performed by faculty, nurses, residents/interns, other institution employees, staff or other students.
Anonymity
If you prefer an anonymous method of reporting, be assured that the complaint will receive the same attention as one with identifiers completed.

However, please note that without identifying information we cannot follow up with questions or concerns, or contact regarding any response and/or corrective action.

Should this complaint be viewed as in violation of Title IX or involve criminal activity, immediate action is required. Due to the severity of this type of complaint, preservation or your anonymity cannot be guaranteed in these specific circumstances.
Contact Information




Incident


For this next section, please be as specific and explicit as possible. This helps ensure that the incident of mistreatment is handled appropriately.

You may skip any questions.









Our priority is to ensure your submitted report receives immediate attention. If you provided your contact information, a member of the investigative team may contact you directly.

If you feel speaking confidentially about this incident would be beneficial, we encourage you to contact a counselor or a College of Medicine Ombudsperson.

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