Student Diversity Grievance Form    

If a member of the Noorda College of Osteopathic Medicine community believes they are the victim of discrimination or harassment, or has information about discrimination in the college community, they may submit the facts of the incident and the names of those involved to the Committee on Diversity, Equity, and Inclusion (CDEI).


This form will provide the CDEI with basic information regarding alleged incidents of protected class discrimination or ethics violations at Noorda College of Osteopathic Medicine.


To provide information regarding alleged incidents of sexual or interpersonal misconduct, please see our Title IX policy.


If you need a reasonable accommodation for a disability in order to participate in this process, please notify CDEI and someone will assist you.


If you would like to remain anonymous with your report please submit it to the Suggestion Box.

Please describe the incident or event as clearly as possible. Include a full description of the event, location, witnesses, verbal statements (threats, requests, demands, etc.), and what, if any, physical contact was involved. If witnesses are involved please include their contact information at the end.

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