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Physical Accessibility Barrier Reporting Form
Please use this form to report physical accessibility barriers on CMU's Pittsburgh campus, such as broken elevators or automatic door openers, blocked wheelchair ramps, impassable walkways, etc.
Personal Information
First Name:
Last Name:
Email Address:
Affiliation
required field
:
Select One
Current student
Faculty
Staff
Visitor
List of Questions
Question 1
: Date of report
required field
Question 2
: What type of physical accessibility barrier are you reporting about?
required field
Broken elevator
Broken automatic door opener
Blocked or inaccessible pathway
Inaccessible ramp
Inaccessible entrance
Broken lift
Bathroom accessibility issue
Inaccessible signage
Other (
Additional Comment Required
)
Additional Comment:
Question 3
: Where on the CMU Pittsburgh campus is this accessibility barrier located?
required field
Question 4
: Please describe the accessibility barrier in more detail. If available, upload pictures or video of the area in question on the next page.
required field
Question 5
: Is this accessibility barrier preventing you from accessing a particular location?
required field
Yes, I am completely unable to access/use the area
Yes, but I have found a workaround as described below (
Additional Comment Required
)
No
Additional Comment:
Question 6
: Would you like to be contacted as a follow-up to your report? If yes, please be sure that you entered your name and email address above.
required field
Yes, please contact me
No, I just wanted to report the issue
Form Submission
Submit Form and Upload Files
Submit Form Without Uploading Files
Office of Disability Resources
Thank you for completing this form. If you requested that a staff member get in contact with you, they will be reaching out shortly. If you have questions in the meantime, please contact the Office of Disability Resources at
access@andrew.cmu.edu
.