Diné College Research Misconduct Allegation Form

Diné College is committed to fostering a research environment that promotes responsible and ethical conduct. We do not tolerate research misconduct and require all personnel to report concerns of suspected misconduct. This form provides a confidential and secure way to submit allegations.

Please provide as much detail as possible to assist in a thorough and fair review. All allegations will be handled in accordance with the Diné College “Procedures for Responding to Allegations of Research Misconduct.”

    --- SECTION 1: Complainant Information ---

    Your Name (Optional):

    Your Email Address (Required for follow-up):

    Your Phone Number (Optional):

    Your Affiliation with Diné College (e.g., Faculty, Staff, Student, Former Employee, Other):

    Do you wish to remain anonymous?
    YesNo

    Note: While Diné College will make every effort to protect your identity, if you choose to remain anonymous, please be aware that complete anonymity may limit our ability to seek clarification or additional information, which could impact the thoroughness of the review. Your identity will be maintained securely and confidentially to the extent allowed by law, disclosed only to those who need to know to carry out a fair proceeding

    --- SECTION 2: Respondent Information ---

    Please provide the name(s) of the individual(s) against whom the allegation is being made.

    Name(s) of Respondent(s):

    Respondent(s)' Affiliation with Diné College:

    Respondent(s)' Role in the Research:

    --- SECTION 3: Allegation Details ---

    Please describe the alleged research misconduct in detail.

    Type of Research Misconduct (select all that apply):

    Detailed Description of the Allegation (be as specific as possible: dates, times, locations, actions):

    Project Title(s) / Research Study Name(s):

    Grant/Contract Number(s) (if known):

    Funding Agency/Agencies (if known):

    Relevant Publications, Manuscripts, or Presentations:

    Relevant Research Records (e.g., lab notebooks, data files, images, consent forms, etc.):

    Date(s) of Alleged Misconduct (approximate dates acceptable):

    Location(s) of Alleged Misconduct (specific lab, department, off-campus site):

    --- SECTION 4: Supporting Evidence and Witnesses ---

    Description of Available Evidence:

    Location of Evidence (specific computer, lab, office, external repository):

    How can this evidence be accessed?

    Are there any witnesses?
    YesNo

    Witnesses' Name(s) and Contact Info (if applicable):

    Upload Supporting Files (optional, max 10MB, PDF/DOC/JPG/PNG only):

    --- SECTION 5: Immediate Concerns ---

    Please indicate if any of the following immediate concerns are present. This information helps the Research Integrity Officer determine if interim actions are needed.

    Immediate threat of harm to public health or safety?
    YesNo

    Are federal funds or equipment at immediate risk?
    YesNo

    Possible Federal criminal violation?
    YesNo

    Is the integrity of the research process at immediate risk?
    YesNo

    --- SECTION 6: Declarations and Acknowledgments ---

    By submitting this form, you acknowledge and agree to the following:
    • Good Faith Allegation: I affirm that this allegation is made in good faith and to the best of my knowledge, the information provided is accurate and truthful. I understand that if it is determined that this allegation was not made in good faith, administrative action may be taken against me.
    • Confidentiality: I understand that Diné College will maintain the identity of respondents and complainants securely and confidentially to the extent allowed by law, disclosing information only to those who need to know to carry out a thorough, competent, objective, and fair research misconduct proceeding. I also understand that during the proceeding, Diné College may disclose identities to legitimate third parties (e.g., journals, IRBs, co-authors) if there is a legitimate need, and that confidentiality may cease once a final determination of research misconduct findings has been made.
    • Cooperation: I understand that I am responsible for cooperating with the inquiry and investigation process, including maintaining confidentiality.
    • Non-Retaliation: I understand that Diné College prohibits retaliation against complainants who make allegations in good faith, and against witnesses and committee members who cooperate in good faith. Any alleged retaliation should be reported to the Research Integrity Officer.

    I affirm that this allegation is made in good faith and to the best of my knowledge, the information provided is accurate and truthful. I understand that Diné College will handle confidentiality, cooperation, and non-retaliation as outlined in the research misconduct policy.