Professional Misconduct Report

All fields are required unless otherwise indicated. Please click Save at the bottom of each page to proceed to the next one. On the last page, click Submit to submit the report.
Reporter type
Your relationship to UAMS
I'm making this report on behalf of someone else.
Which choices apply to the complaint? You may choose more than one.

    if "Other violations", please enter:
Information about the accused person
Relationship to UAMS

Accused person's name (if you don't know it, enter Unknown).

Accused person’s description (if you don’t have a name, describe only the accused person here).


Click Save to save information about you and the accused person(s). On the next page, you will enter details about the incident.