UMass Boston

Referral & Complaint Forms


  • If this is an Emergency, please contact 911.

UMass Boston utilizes Maxient software to manage various pieces of students' records. Through Maxient, we are able to use its centralized reporting and recordkeeping 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, the Student Referral Program (SRP), 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. 
  • [Academic] Student Referral Program Form (SRP)
    This form is to be used if you have concerns about a student’s classroom academic performance. Typical referral reasons include: excessive absences, low test grades, writing or organizational challenges, unresponsiveness to faculty outreach, and/or personal issues affecting performance. For more information see the Student Referral Program website.
  • Appeal Form
    This form is used to appeal decision outcomes following an Investigation by the Dean of Student’s Office.  More information about the Code of Conduct and Community Standards procedures.
Dean of Students Office
Campus Center, Floor 2

If this is an emergency call 911