Reporting ADA Deficiencies
Problem Description of ADA Deficiency
Campus Name:
Building Name:
Please choose one
Building Number:
Floor Level:
Room Number:
Restrooms:
Please choose one
Ladies
Men
Elevator Accessibility Need:
Indoor or Outdoor Travel Path Accessibility Need:
Full Description of Access Problem:
Reporter Information
Name:
I am a:
Please choose one
Student
Faculty member
Staff
Department (Staff and Faculty):
College (Student):
Phone Number:
Phone Extension:
Email Address:
