Dispute Resolution Form '23

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University Academy’s policy is to review services when complaints or concerns arise.
Please complete this form to have your concern/complaint addressed.
Step 1: Discuss complaint/concern with appropriate person/individual responsible for
school/department/program
Step 2: Appeal to appropriate Principal or Central Office supervisor
Step 3: Appeal to Superintendent

Email *

Complaint or Concern Initiated by: *

Address (Street Number)

City *

Zip Code *

Telephone *

I have a complaint/concern regarding: *

My specific complaint/concern is: *

My recommendation to resolve my complaint/concern is: *

I have discussed my complaint/concern with the following persons: *

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