The code block below illustrates how one might use # and // as comments in your logic and calculations.

This value you provided is not a number. Please try again.

This value you provided is not an integer. Please try again.

The value entered is not a valid Vanderbilt Medical Record Number (i.e. 4- to 9-digit number, excluding leading zeros). Please try again.

The value you provided must be within the suggested range

The value you provided is outside the suggested range

This value is admissible, but you may wish to double check it.

The value entered must be a time value in the following format HH:MM within the range 00:00-23:59 (e.g., 04:32 or 23:19).

This field must be a 5 or 9 digit U.S. ZIP Code (like 94043). Please re-enter it now.

This field must be a 10 digit U.S. phone number (like 415 555 1212). Please re-enter it now.

This field must be a valid email address (like joe@user.com). Please re-enter it now.

The value you provided could not be validated because it does not follow the expected format. Please try again.

Required format:

4v8FQ4BYPVkPd3dmJN7Fvi4fCQjRxI9NqPqjrYsR29AhiGpkd7DFriXYdsYdRZxh

Mistreatment Concern(s)

UT Southwestern is committed to promoting a supportive educational environment where students are treated with respect and where altruism, accountability, duty, and integrity are nurtured. We need your help to address problem areas early. Thank you for considering reporting your concern.

Please note that only Drs. Mihalic and Barker will have access to information provided in this survey. One of them will contact you if additional information is required or needed to address your concern. Your identity will be kept as confidential as possible, and we will do everything possible to ensure you are protected. Retaliation will not be tolerated.

Your concern

* must provide value

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If you have a preference for which Dean contacts you, please indicate who you prefer.

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Dr. Mihalic

Dr. Barker

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Your name

Your cell number

Rotation or course in which incident occurred

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Role of person(s) involved

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If other, please specify:

Category of behavior

* must provide value

If other, please specify:

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