Website Access Barrier Reporting – Access 4 All

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Public Place Access Barrier Reporting
Website Access Barrier Reporting

Website Access Barrier Report

Step 1 of 2 - Barrier Info

50%

URL

This field is for validation purposes and should be left unchanged.

Advocate Name(Required)

Website Address(Required)

Date of most recent visit(Required)

MM slash DD slash YYYY

Type of business and reason for your visit.(Required)

What barriers did you have visiting this website?(Required)

Screenshot(s) / Screen Reader Video

Drop files here or

Max. file size: 64 MB.

Was anyone with you?(Required)

Yes

No

Will they verify how the impediments created by the barriers affected you?

Yes

No

Device Used(Required)

Desktop / Laptop

Phone / Pad

Desktop / Laptop

Phone / Pad Type

Browser Used(Required)

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