College of Medicine Medical Student Concern Form

This form is being completed due to an important concern associated with one or more of the medical student competencies for graduation. 

Course, clerkship, other








The faculty member must provide the student with a copy of the form after reviewing it with them.
 

The faculty member will receive an emailed copy of the concern form when submitted.  Copies will also automatically be sent to Drs. Manny Williams and Britta Thompson.