WheeliWorld - End-User Survey
WheeliWorld aims to help users discover their independence in daily life.
Name
Email Address
Age Range
Zip Code
Do you have a mobility issue?
Clear selection
What tools do you currently use to find accessible places?
check all that apply
Do you drive?
check all that apply
Do you use any of the following public transportation types?
check all that apply
Do you travel?
check all that apply
Do you use any of the following?
check all that apply
What type of venue do you frequently visit?
check all that apply
Please rank your greatest needs when going to a venue:
1 being lowest need and 5 being greatest need
1
2
3
4
5
Parking
Entranceway
Bathroom
Elevator
Clear selection
Please rank your biggest concerns when parking:
1 being lowest need and 5 being greatest need
1
2
3
4
5
Distance from building
Limited number of standard accessible spots (60-inch access aisle)
Limited number of van accessible spots (96-inch access aisle)
Uneven surfaces
Clear selection
Please rank your major concerns in bathrooms:
1 being lowest need and 5 being greatest need
1
2
3
4
5
Size of stall
Toilet height
Sink height
Counter height
Soap dispenser height
Paper towel or hand dryer height
Light switch height
Counter Height
Shower access
Accessible family bathroom
Clear selection
Please rank your greatest obstacles in entertainment venues:
1 being lowest need and 5 being greatest need
1
2
3
4
5
Hi table height
Low table height
Thick carpet flooring
Skinny isle width
Clear selection
Please rank your greatest concerns when entering a building:
1 being lowest need and 5 being greatest need
1
2
3
4
5
Can't locate accessible entrance
Slightly steep ramps
Curbs
Elevator button height
Lack of automatic door
Clear selection
List the 3 top venues that you visit on a regular basis because they are accessible:
Recommend venues you would like WheeliWorld to add to the online directory (include venue name and city):
Do you know venue owners/managers who would like their venue included in the online directory? (include venue name, city and contact information)
May we add you to our contact list for WheeliWorld updates?
Clear selection
Any other comments/suggestions/questions you may have for WheeliWorld?
Thank You
Thank you for taking the time to fill out our survey to help WheeliWorld
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