The Office of the Dean of Students strongly encourages individuals to make an appointment by calling 719-255-3091, emailing, or contacting a specific staff member using our staff contact information.


Submit a Concern / Report an Incident


Submit a Concern / Report an Incident

Before You Begin

In the event of a health or safety emergency, please call UCCS Police at 719-255-3111 or dial 911.  

For concerns of protected class discrimination or harassment, domestic violence, dating violence, stalking, sexual harassment, or sexual misconduct, please submit a report to the Office of Institutional Equity here

This form can be used for:

1) Concerns about a student's mental health and well-being (non-life threatening) or to request resource information for a student  
2) Concerns about disruptive or inappropriate behaviors (Faculty, please consider if the Academic Disruption Procedure applies)
3) Concerns about a student’s access to basic needs

All fields marked with (*) are required. You may choose to remain anonymous, but your identity may help us in the investigation.


Concern Information

Be as detailed as possible. The more information, the better we can assist you. If more than one student is involved, please submit an additional referral.  

Is the student aware that a referral is being submitted on their behalf?


Tell Us About You

Please share your contact information so we can follow up with you. If you would prefer not to be contacted, select "No Thanks" at the end of this section.

First and Last Name:
I am a:
Preferred Way to Contact You: