Anonymous Feedback Form | Climate & Culture | Washington University in St. Louis

Please use this form to send the task force your input on the academic culture at the medical school. To protect your privacy, this form does not collect IP addresses. Any identifying information you might provide is voluntary.

You are also welcome to email us at medculture@wustl.edu.

Anonymous Feedback Form

Please share your perspective, concerns and potential solutions with the Task Force.

This form is to be used for broader themes, ideas and observations regarding the academic culture at WashU School of Medicine. If you wish to report a specific incident of misconduct or mistreatment, please use the appropriate channels to report.

I understand that submitting this form is not considered a formal report of discrimination, harassment, or other misconduct or mistreatment. This form is to be used for general feedback to be taken into consideration by the Task Force. Depending on what information is shared in the survey, the university may have an obligation to follow up.

Optional fields:

What is your affiliation with Washington University School of Medicine? (optional)

If you would like us to follow up with you, please provide your email address or phone number below. (optional)

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