SHS Staff Feedback

The below feedback form is available for Student Health Services staff use only.

OPTIONAL: Submitter's Name
First Last
Important: Your submission will remain confidential. If you would like your feedback to remain anonymous, please do not include your personal information. Reports submitted anonymously or with limited information may limit the ability to follow up on a report. To ensure that appropriate action can be taken to address your comment, concern, complaint, compliment, etc., please provide a detailed description in the feedback area below.
OPTIONAL: Email Address
Please leave feedback below:*
Please include your comments, compliments, complaints, etc. in this section. Please be as detailed as possible with your feedback. If there are any questions regarding this form, please speak with your supervisor.
Have you discussed this with your supervisor?
To which individuals would you like to submit this feedback form?*
Please check the box of the individual(s) to whom you would like to submit this feedback form. If you would like more than one group to receive this feedback form, please check all appropriate boxes.
- SHS Director (Interim, Dr. Skaggs)
- Administrative Directors (Dr. Skaggs, Richard Darnell, Judd Moody, Tanja Peterson)
- SHS HR Liaisons (Tanja Peterson, Abby VandenBrink)
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Phone
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