Fraud, Waste or Abuse Reporting Form

Be Reasonably Certain!

Before making any allegations of fraud, waste or abuse, be reasonably certain of such claims. Such allegations may seriously and negatively impact the accused individual’s life and adversely affect the working environment of the university.

Tennessee Code Annotated 39-16-502, False reports, states that it is unlawful to make a report if:

The offense or incident reported did not occur;
The person has no information relating to the offense or incident reported; or
The information relating to the offense reported is false

In your own words, please describe the who, what, when, where and how of the fraud, waste or abuse:

Name(s), job title(s), department(s) of the individual(s) involved:

Date of occurrence:

Time of occurrence:

Describe how and when you became aware of the issue being reported:

If you have reported your concern to any other department or agency, to whom did you report your concern:

If you wish to remain anonymous, you do not have to provide your contact information. We encourage you to provide your contact information for any follow-up questions that may arise during our review or to obtain a copy of the final report at the completion of the review. All contact information provided is considered confidential under TCA 49-14-103. However, if the university has a separate legal obligation to investigate the complaint (e.g. complaints of illegal harassment or discrimination), Internal Audit cannot guarantee anonymity or complete confidentiality.

Name :

Work Phone Number :

Alternative Phone Number :Please only click “submit” once. The form submission process takes a moment to complete. You will be taken to a confirmation page when the process has completed.