Accessibility Form
This form is to be filled for the sole purpose of informing BRIDGES of the accessibility for the location you visited. Please fill the form out as detailed and complete as possible and answer only what applies to you.
Email address *
Name of Location:
Your answer
Date Visited:
MM
/
DD
/
YYYY
Wheel Chair Accessibility:
Please respond to the questions below based on the wheel chair accessibility (WCA) of the Venue/Location in your previous answer to the initial query of this form (Name of Location:), if applicable:
WCA-Parking Lot:
WCA-Main Area:
WCA-Bathrooms:
WCA-Service Quality:
WCA-Additional Comments on your Experience:
Your answer
Accessibility for Blind/Visually Impaired/Low Vision:
Please respond to the questions below based on the Accessibility for Blind/Visually Impaired/Low Vision (BVIL): of the Venue/Location in your previous answer to the initial query of this form (Name of Location:) if applicable:
BVIL-Ease of navigation
BVIL-Service Quality
BVIL-Additional Comments on your Experience:
Your answer
Accessibility for Deaf or Hard of Hearing:
Please respond to the questions below based on the Accessibility for Deaf or Hard of Hearing (DHH): of the Venue/Location in your previous answer to the initial query of this form (Name of Location:) if applicable:
DHH-Ease of navigation
DHH-Service Quality
DHH-Additional Comments on your Experience:
Your answer
Accessibility Experience as a person with Invisible/Medical Disability:
Please respond to the questions below based on the Accessibility Experience as a person with Invisible/Medical Disability: (IMD): of the Venue/Location in your previous answer to the initial query of this form (Name of Location:) if applicable:
IMD-Ease of navigation
IMD-Service Quality
IMD-Additional Comments on your Experience:
Your answer
A copy of your responses will be emailed to the address you provided.
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This form was created inside of BRiDGES.