Student Feedback and Equity Concerns

You can use this form to describe feedback, both positive and negative, about anything including issues related to your experience as a student at Gillings, administrative processes, and classroom activities. This form will also allow you to specifically describe incidents in which racial or other equity-related bias, or microaggressions, occurred. You may submit this form anonymously. However, for us to follow up and provide the necessary support, we encourage you to include your contact information. For further information, please visit the Student Feedback and Equity Concerns FAQ.

Please note that this form does not take the place of any University process or policy. If you would like to report an incident under the University’s policy on Prohibited Discrimination, Harassment, and Related Misconduct including Sexual and Gender Based Harassment, Sexual Violence, Interpersonal Violence, and Stalking, please visit Safe At UNC or the Equal Opportunity and Compliance Office (EOC) for additional information, including resources, contact, and reporting options.

All information is held privately to the fullest extent possible in accordance with federal and state law. UNC strives to honor the wishes of individuals submitting information but may need to pursue additional actions to protect the health and welfare of impacted persons and the broader University community. Depending on the nature of the concern, the UNC EOC Office could be contacted to provide further assessment. Should this occur, you will be notified of these next steps.

The bias-related questions in this form were adapted from the NC State Bias Reporting Tool. These questions are included with the goal of advancing Gillings’ commitment to diversity, equity and inclusion among our faculty, staff and students, and stem from the belief that all people should be treated with civility, dignity and respect.

* Indicates a required field.

Please indicate your department or concentration
Please indicate your degree or certificate program
Would you like to describe a bias-related incident, such as a microaggression or macroaggression, or simply leave feedback or a question?*
We strive to uphold the privacy wishes of those who submit information. It is important to note that, to comply with federal, state and local laws, as well as UNC policies, some information may be required to be shared per the guidance outlined here: https://eoc.unc.edu/what-we-do/address-misconduct/responsible-employees/.*
What follow-up would you like after you submit this form?*
If you would like an update on the status of your question, concern or suggestion, we ask you to consider providing the following contact information: If you have requested or allowed follow-up contact above, please provide the following contact information:
Location of incident*

The bias-related incident focused on the following actual or perceived identity(-ies): (please select all that apply)*

As the person providing this narrative, I am:*

  • What happened?
  • When did this behavior/incident occur?
  • Whose behaviors created the incident? Please name this person/people if you are comfortable. If you’re not comfortable using someone’s name, please tell us what role they play (e.g., student, visiting lecturer, advisor, professor, TA)
  • What impact has this incident/behavior had on you or on others?
  • Who may be impacted?
  • Have any immediate needs been identified?
  • What concerns you most about what happened?
The person(s)/group(s) impacted was a: (check all that apply)*
The person(s)/group(s) engaging in bias-related behaviors/actions was a: (check all that apply)*