Request For Assistance

NOTE: Any information given on this form will only be used for the purposes of this Office.

Please remember that e-mail is not appropriate for confidential communication. As a minimum, please provide contact information. However, we will be able to serve you best if this form is as complete as possible.

* In order for us to respond to your request, you must provide either your telephone number or e-mail address

       

Date:
(yy/mm/dd)
Contact Information  
Name:
*E-mail:
*Telephone:
Constituency

 Undergraduate Student

Faculty: Department:

 Graduate Student

Faculty: Department:

 Academic Staff

Faculty: Department:

 Administrative Staff

Faculty: Department:

 Dentistry Clinic Issue

 Campus Police Issue

 Not Enrolled - Admissions Issue

 Other (specify)

 

Please provide a brief outline of your reason for requesting assistance from this Office (up to 7000 characters):

Before coming to the Office of the University Ombudsperson, have you discussed this matter with other UofT offices/individuals?
 No
 Yes. Which offices/individuals? (choose all that apply)

Undergraduate Coordinator / Associate Chair

Vice Dean SGS

Registrar's Office

Department Chair

Student Government Rep

Accessibility Services

Human Resources

Graduate Coordinator / Associate Chair

SGS Conflict Resolution Centre

Professor

Supervisor

Union Representative

Office of Student Life

Equity Office

Other

 

How did you hear about the Ombudsperson's Office? (choose all that apply)

Bookmark

Poster

Social Media

Campus Student Screens

Student Govermment

Faculty Member

Registrar

Calendar

Website

Graduate/Undergrad Coordinator

Student Life

Another Student

Friend/Family

Other


Note: You may wish to leave this section blank until you have discussed your situation with us.
I authorize the Ombudsperson to access my UofT record, and to contact UofT representatives about my concern.

yes     no


Click once to submit this information then contact the Office to make an appointment to discuss your situation in more detail.

Phone: (416) 946-3485
E-mail: ombuds.person@utoronto.ca

Click once if you want to clear ALL the fields in the above form.