Accessibility Feedback Survey

Accessibility Feedback Survey — Form Fields

This surveys template includes 6 fields. Gather feedback on how accessible your products, services, or facilities are for people with disabilities. Use responses to prioritize accessibility improvements. Free to customize and use on ZenBuild.

• Which area are you providing feedback on? (dropdown selection, required) — options: Website / digital product, Physical location / building, Customer service interactions, Printed or written materials, Events or programs
• How accessible did you find this experience overall? (rating, required)
• Did you encounter any barriers that limited your access? (multiple choice, required) — options: No barriers encountered, Minor barriers, Significant barriers, Could not complete task due to barriers
• Please describe any barriers you encountered. (long text, optional)
• What improvements would make the biggest difference for you? (long text, optional)
• Email address (optional — if you'd like us to follow up) (email, optional)