Employee Concern Form

This form is designed to provide Adelphi University employees with an easy method to report specific information related to an issue or concern.

You are not required to complete the entire form in order for it to be submitted; however, if the report does not contain some specific information, an effective response cannot be conducted. For example, if the complaint is "the back office work space in the department is not adequate to meet with employees privately to discuss confidential issues," then this concern can be reviewed. Conversely, if the report states that "all basement offices should be moved" then an effective review cannot be conducted.

To report allegations of discrimination, harassment (including sexual misconduct, relationship violence or stalking) and retaliation, please refer to the Title IX.

"*" indicates required fields

Your concern pertains to:*
Please be as detailed as possible.

If you wish to identify yourself, please enter your name and phone number for contact purposes:
Name
This field is for validation purposes and should be left unchanged.
Contact
Phone Number
More Info
Location
Levermore Hall, 203
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