Student Code of Conduct Complaint Form
This form is used by faculty, staff, or students to submit a referral for alleged misconduct by a student related to the UAH Student Code of Conduct. Please note, the accused student will receive a copy of the complaint as part of the process to resolve the matter.
Should you wish to make an anonymous report pertaining to sexual violence, discrimination, harassment, and/or hazing, please contact the UAH Hotline at 256-824-STOP (7867).
Name of Person Filing Complaint
Address of Person Filing Complaint
Phone Number of Person Filing Complaint
Email address of Person Filing Complaint
Name (s) of the person or student organization against whom this complaint is filed:
Address of the person against whom this complaint it filed:
Phone number of the person against whom this complaint is filed:
List addresses & phone numbers of any other students against whom the complaint is filed:
Brief statement of facts on which the charge of misconduct is based.
Type of misconduct(s) charged:
Controlled Substance Abuse/Misuse
Damage, Theft, or Unauthorized use of Property
Disorderly or Indecent Conduct
Failure to Comply
Misuse/Abuse of Computing Resources
Other Physical or Mental Abuse or Harm
Unauthorized Disclosure of Sensitive Information
Violations of Law, Order, or University Imposed Regulations or Sanctions
Weapons, Firearms, or Explosive Devices
Please upload any documents that may support this complaint.
Please upload any additional documents that may support this complaint.
Do Not Fill This Out