ADA Barrier Reporting

Background Information

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Your full name:

Your position/title:

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Employee, student, parent, guest

Your phone number:

Your email address:

Email address must be of a valid format.

Your physical address:

Nature of this report(Required):

This field is required.

List any person(s) or groups involved

Please provide us with as much contact information as possible to assist us in resolving the issue.

Name or Organization

How was this person involved

ID Number

Phone number

Email address

Questions

Please provide as much detail as possible to assist the university in investigating the report.

Please describe the barrier to access?(Required) This field is required.

Who have you already discussed this issue with prior to submitting this report?(Required) This field is required.

If you have already met with someone what were the outcomes of that discussion? This field is required.

Do you have any suggestions for solving the issue? This field is required.

If there are witnesses involved in the incident, if possible, please list their names and contact information . This field is required.

Supporting Documentation

Photos, video, email, and other supporting documents may be attached below. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Email me a copy of this report

Background Information

List any person(s) or groups involved

Questions

Supporting Documentation

Submission