Name:

[Your Name]

Age:

[43]

1. Have you faced any difficulties accessing our administrative services?

• Yes

• No

2. Have you encountered any inaccessible areas within our facilities?

• Yes

• No

3. Have the accommodation requests been handled to your satisfaction?

• Yes

• No

4. Do you have any suggestions to improve our accessibility?

5. Rate your ease of navigation within our facilities.

• 5 - Very Satisfied

• 4 - Satisfied

• 3 - Neutral

• 2 - Dissatisfied

• 1 - Very Dissatisfied

6. How would you rate our staff's knowledge of accessibility issues?

• 5 - Very Satisfied

• 4 - Satisfied

• 3 - Neutral

• 2 - Dissatisfied

• 1 - Very Dissatisfied

7. Do you have any suggestions to improve our accessibility?

   • Yes

   • No

   If yes, please specify:                                                                                                                        

                                                                                                                          

8. Do you feel that we comply with the Americans with Disabilities Act (ADA) and similar laws?

• Yes

• No

9. Are there areas where our compliance could be improved?

   • Yes

   • No

If yes, please specify: