Urgent Resolution Request

Before filling out this request, we ask that you make at least 2 attempts to resolve the issue directly with your instructor while waiting an adequate amount of time for their reply. Typical instructor response time is 24-48 hours after each attempt.

Concerning contact information
Please note that retaliation against a student for making a complaint is absolutely prohibited and will be considered a serious violation of professional responsibility.

Please fill out the form below to get started.

Your First Name

Your Last Name

Your Student Email Address

Ex. jdoe6@student.umpqua.edu

Preferred Method of Contact

If "Do Not Contact" selected, form will be handled anonymously.

Your Phone Number

Cell phone is best

Information about the issue

Class CRN or description

Instructor's Name

How did you contact the instructor regarding this issue?

Canvas

Umpqua Email Address

Phone

Other

If other, explain:

When did you first contact the instructor?

When did you last contact the instructor?

If other, explain:

Please describe the issue.

Resolution

What resolution do you consider to be fair?

Please provide any additional information

By checking the box below, I hereby certify that the above information is true and accurate to the best of my knowledge. I grant permission for this information to be forwarded to any officials necessary to ensure resolution.