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OptionalPlease provide the following demographic information. Even though this information might be irrelevant to the issue for which you are seeking assistance, it's important for our record keeping. We would appreciate your sharing the following information, but we respect your right to not provide it.
I authorize the Office of the Ombuds to discuss this matter with the following additional individuals and departments (specify names):
I have attempted to resolve this matter but could not find a neutral or "reasonable" solution to the problem. Therefore, I am authorizing the Office of the Ombuds to discuss my concern with anyone involved to help find an informal resolution to this matter. I understand that the Office of the Ombuds is confidential, informal, and neutral. The Office of the Ombuds it is not an advocacy office. I also understand that communications to the Office of the Ombuds does not constitute notices to the University nor to its staff. I understand that, due to the limitations of technology, confidentiality cannot be assured when using e-mail. By submitting this form, I am authorizing the Office of the Ombuds to address my concerns via e-mail, at meetings, and telephone conversations.
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Ypsilanti, MI, USA 48197
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