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Academic Integrity Violation

This form should be used to report potential violations of the LKSOM Policy on Academic Dishonesty and Impropriety. You are also encouraged to discuss the potential violation with a faculty mentor, the MAUB program’s senior advisor, or the director of the MAUB program.

All reports will be kept confidential. Upon submission of this form, an email will be sent to the head of MAUB Student Performance Committee who will convene a meeting of the committee to determine the next steps.

You will find the Lewis Katz School of Medicine policy on AI here.

Academic Integrity Violation

Your Name (optional)
Please note that if you remain anonymous the committee will not be able to reach out to you for more information.
Please describe the potential violation, including all pertinent details – the person’s name, time, place, and circumstance of what you observed.
Is there anything else you would like to share with the committee?