Qualtrics Survey | Qualtrics Experience Management

Please complete the information below.

Student's Name/U#

Student's UofM Email Address

Mobile Number

Semester/Term of submitted concern (Fall 2021, Spring 2022, etc)

Please choose type of concern below.

Advising Concern
Placement Concern
Licensing/Certification Concern
Course Related Concern (Please list name of the course instructor and course below).

Please share a detailed summary of your concern below.

Please upload any documentation related to your concern.