Student Grievance/Complaint Form

At Columbus Technical College we are committed to providing a supportive and fair educational environment. We recognize that students may occasionally have concerns or grievances that need to be addressed. This Student Grievance/Complaint Form is designed to provide a formal mechanism for students to report their issues and seek resolution. We take all complaints seriously and aim to address them promptly and equitably. Please provide as much detail as possible to help us understand and resolve your concern effectively.

Date
Date Format: MM slash DD slash YYYY
Name*
First Last
Student ID Number
Phone
Email*
Program of Study/Major
Incident Being Grieved:*
Brief description of incident being grieved:
Remedy requested:
Informal remedy attempted by student and outcome:
File
Please add any supporting documentation.
Consent*
I read and agree to the procedure below.
"I hereby consent to the collection, use, and disclosure of the information provided in this form for the purpose of investigating and resolving my complaint. I understand that my personal information will be kept confidential to the extent possible and will only be shared with individuals directly involved in the complaint resolution process. By submitting this form, I acknowledge that I have read and agree to the terms of this consent."

Tara Askew

Student Grievance/Complaint Form

Student Grievance/Complaint Form

Author

Division of Health Sciences and Nursing

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