This is a form that can be filled out in order to both evaluate businesses and provide necessary information to anyone who is concerned about accommodations. I created this form for the purpose of creating an accessibility review blog for my local area, but I would love if other people were able to use it.
Feel free to use and spread.
@accessibilityfails This blog was largely responsible for my coming up with the idea
[Image Description: Two photos showing two laminated pages with the following text... "Accessibility Review
Location: (blank space)
Address: (blank space)
Parking Access
Parking? Yes or No. Location type: Lot / Street / Other (blank space)
Accessible Parking? Yes or No. Distance from Entrance: (blank space)
Any Barriers or Obstacles from Parking to Entrance: (blank space)
Public Access
Sidewalk to entrance? Yes or No. Condition: (blank space)
Bike stands? Yes or No
Nearest Bus Stop: (blank space) Distance from entrance: (blank space)
Business name/logo/address clearly visible? Yes or No
Entrance/Exit Access
Most accessible entry point: (blank space)
Accessible doors? Yes or No. Type of accessible door: Auto / Small Button / Large Vertical Button
Curb or step? Yes or No (number of) Inches. Stairs? Yes or No (number of) Steps
Ramp? Yes or No. Incline? Good / Okay / Steep
Any other usable entrance/exit points: (blank space)
Indoor Access
Enough Space to Maneuver Mobility Aids? Yes or No
If not, state reasons or obstacles: (blank space)
Floor Texture: Rough, Matte (safer for cane users) / Smooth, Shiny (more hazardous for cane users)
Uneven Flooring? Yes or No. If so, how severe: Slight Sloping / Noticeable Sloping
Seating Available? Yes or No. Type of Seating: (blank space)
Additional Floors? Yes or No. Elevator Access? Yes or No
Bathroom Access
Bathroom? Yes or No. Customer Only? Yes or No. Accessible Stall? Yes or No
Accessible Bathroom? Yes or No. Accessible Door? Yes or No
Accessible Amount of Space? Yes or No
Grab Bar? Yes or No. Placement: (blank space)
Change Table/Area? Yes or No. Supports: Children Only / Children or Adults
Sink/Soap/Towels Reachable by Wheelchair? Yes or No
Any Additional Features or Issues: (space for writing)
Available Accommodations
Disability Services? Yes or No. Contact for Accommodations: (blank space)
Sign Language Interpreting (specify): (blank space)
Spoken Language Interpreting (specify): (blank space)
Subtitles: In Spoken Language / Other: (blank space)
Mobility Aids: Borrow / Rent ($_____). Electric Cart / Electric Chair / Manual Chair / Walker
Sensory Information
Lighting: Bright / Well Lit / Dim Direct / Indirect. Florescent / Incandescent / Other
Loud Sounds? Yes or No Continuous? Yes or No. Description: (blank space)
Background Sounds: (space for writing)
Scents: (space for writing)
Temperature: Above 24C / 24C – 21C / Below 21C
Air Quality: Clear / Dusty / Smoky / Other: (blank space). Well Ventilated / Adequate / Stuffy
Praise, or pleasant surprises: (space for writing)
Criticisms, or negative experiences: (space for writing)
End Image Description]
