Request Accessibility Review

Please fill out this form in its entirety, including as much information you can provide about the app or site you want reviewed for accessibility. If a particular question does not apply to the app or site, check the N/A box or type N/A in the edit field for that question. If you have questions or need assistance, call or email Terri Hedgpeth, Ed.D. at 480-965-6278, terrih@asu.edu.

Department, name and contact information requesting the Accessibility Review:

Department / unit name:

Name:

Phone number:

ASURITE ID:

Email address:

App / site information

What is the name of the app or site that you want evaluated for accessibility?

Please provide a description of the app or site:

What is the URL where the app or site can be accessed?

If no URL, how do we access the app?

Is this product designed for PC and/or mobile platform?

PC / laptop / Apple

Mobile device

Vendor specific device

Other

If other, please specify:

Does the URL or location provided for this app or site give full access to the content that a potential user would access?

If you answered no, please explain.

If it is a current app or site you are using, what motivated you to request a review at this time?

Who will be using this app or site?

ASU staff

Student staff

For student use

Other

If other, please specify

Please list all functions, use cases, and/or tasks for each user group below.

Staff:

Students:

Families and other community members:

Other (specify):

Is there a Voluntary Product Accessibility Template (VPAT) available that you can share?

If this is an application, are there alternative applications you are considering?

If yes, please list them by name and vendor below.

Is this a new app or site you are considering?

If yes, what is your projected launch date?

Is there a vendor for this particular app or site?

Vendor information

Vendor's name:

Contact's name

Contact's phone number

Contact's email address

Additional information

If applicable, please provide log-in and password credentials for accessibility testing purposes:

Requested testing start date:

Targeted testing completion date:

Do you have any additional information that you would like to add that might help with the Accessibility Review?

Tested on

Notes