University of Pittsburgh

Professionalism or Mistreatment Incident Report Form

We value professionalism at Pitt Med.

The purpose of this professional incident form is to enable a confidential reporting mechanism for learners and faculty to identify any mistreatment or unprofessional conduct they have experienced within any of the learning environments of the School of Medicine.

This form should be used for reporting incidents only and should not be used for emergencies.

All forms will be reviewed within 72 hours of submission, and will be triaged according to level of urgency.

All individuals who submit this professionalism incident form will receive a summary of the conclusion of the investigation, should they choose to provide their email address.

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