UMass Boston

Referral Forms

Referral and Complaint Forms

UMass Boston utilizes Maxient software to manage various pieces of students' records. Through Maxient, we are able to use its centralized reporting and record keeping features to help our community connect important information to prevent students from falling through the cracks. From issues involving discrimination, care and concern referrals, student discipline, U-ACCESS, and general concerns for the Dean of Students Office, Maxient is critical to all things related to a student's conduct and well-being.

Please be aware that these forms are not to be used during an emergency. If this is an emergency, please call 911.

Additionally, the filing of a report does not constitute filing an official police report. To file an official police report, contact the UMass Boston Police Department (617.287.7780) or in person on the first floor of the Quinn Administration Building. For incidents occurring off-campus in the City of Boston, call 617.343.4730

Online referrals may be made through the following links:  

  • Care Case Management Referral Form
    This form is for faculty, staff, and students to report students who are experiencing crisis, displaying odd or unusual behaviors, or engaging in other behaviors that may be perceived as being harmful to themselves and/or others. 
  • Student Conduct Referral Form
    This form is used to report suspected violations of the Student Code of Conduct and other behavioral concerns.
  • Office of Civil Rights and Title IX Complaint Form
    This form is to be used for reporting information necessary to initiate an investigation of alleged discrimination, harassment, sexual or gender-harassment, sexual assault, or other sexual violence, stalking or retaliation pursuant to the Discrimination and Harassment Policy and/or the Student Code of Conduct. 
  • U-ACCESS Referral Form
    This form is to be used if you have concerns regarding temporary homelessness, emancipation from foster care, chronic poverty, chronic hunger, and financial hardship.
  • Dean of Students Referral Form
    If you are not sure which form to use to report an issue, please select this form and it will be routed to the appropriate office for follow up. 
  • Appeal Form
    This form is used to appeal decision outcomes following an Investigation by the Dean of Student’s Office. 

Forms for Academic-Related Concerns

The following forms are routed to the Center for Academic Excellence and are not associated with the Dean of Students Office.

  • Academic Student Referral Program (SRP). Faculty should use this form to refer students to the Center for Academic Excellence for assisting with:
    • Any academic issue
    • Unresponsiveness to faculty email outreach
    • Improving study skills, writing skills, and organizational skills
    • Improving quiz / test grades
    • Reducing absences from class
    • ESL challenges
  • Academic Integrity/Plagiarism Reporting Form. Faculty should use this form if they suspect a student has violated the Academic Integrity policy. 
 
Questions? Please contact us!
Dean of Students Office
Campus Center, Floor 2
 617.287.5800
 dean.students@airalkalimilagros.com

If this is an emergency call 911