Concern and Complaint Form

Concern and Complaint Form

by Pacific College eLearning -
Number of replies: 0

Students, Faculty and Staff,

As part of our ongoing efforts to improve how we operate the college and to try and make it as easy as possible for members of our community to voice any concerns they have, we have moved our Concern and Complaint Form into the college ticketing system.  

Instructions for completing the form and frequently asked questions can be found here:

Pacific College of Health and Science








When should I use this form?

Please complete this form when you have a concern or complaint and when the following applies: 

1. You have tried to address the concern directly with those involved where appropriate without success and/or 

2. You have discussed the concern with your faculty instructor, clinic supervisor or staff member where appropriate without success and/or 

3. In any situation where you do not feel comfortable trying to work this issue out on your own 


This form is not for use in emergency situations.  In the event of an emergency, please call 911


What is the difference between an informal and formal complaint?

Typically, an informal complaint process is a fully voluntary, structured interaction between the parties that is designed to help them address and resolve an issue at the earliest stage possible. The goal of an informal complaint is to attempt to reach a resolution to the concern that is acceptable to both the complainant(s) and the respondent(s). Pacific does not make a determination as to whether a respondent(s) has violated college policy. Instead, staff will use conflict resolution techniques to attempt to resolve the concern(s) brought forward. This is a flexible process that invites active participation of all the parties in order to resolve the complaint.


A formal complaint should be submitted with the person filling the concern/complaint believes the issue is more serious in nature and that the formal process would be best to ensure the issue if fully resolved and appropriate action is taken to stop the unwanted behavior and protect against any recurrence.


Can I be assured that the my concern will be anonymous?

The college recognizes that confidentiality is important. Anyone who suspects that they have been a victim of harassment or discrimination is encouraged to report the matter. The college will make every effort to respect the confidentiality and privacy of all parties involved. When looking into the matter, particularly when a grievance is filed, the school will pay attention to any due process or other rights the accused might have. However, the school will make sure that doing so does not interfere with the protections provided to the complainant that are protected by law. 

Sometimes, a person complaining of harassment or discrimination may ask that the school, in its investigation, not use the person’s name. Similarly, a person may even ask that the school take no action. In these situations, the school’s ability to deal with the alleged harassment or discrimination may be limited. However, the school may still be able to take some steps to address the matter. For example, the school will, at its minimum, report a sexual assault or other possible criminal activities to the police, even without a complaint from the person. In less severe cases, the school will at least keep track of the incident so that it can identify and take action against repeat offenders. However, when faced with a request for confidentiality or to take no action, the school must consider whether the alleged harassment or discrimination may affect other students, faculty or staff. If so, the school may need to take action to prevent those persons from being harassed or discriminated against. 

Pacific College offices and employees who cannot guarantee confidentiality will maintain complainant privacy to the greatest extent possible. The information provided to a non-confidential resource will be relayed only as necessary for the Title IX Coordinator to investigate and/or seek a resolution.