Reporting of Accessibility Issues / New Form

The University of Illinois Chicago (UIC) is committed to maintaining a barrier-free environment so that individuals with disabilities can fully access buildings/facilities, programs, services, and all activities at UIC.

The information submitted on this form will be reviewed by the UIC ADA Coordinator located within the Office for Access and Equity. All matters will be reviewed by the ADA Coordinator and appropriate campus officials in order to resolve the issue being reported.

Please provide your contact information if you wish to be contacted regarding the reported issue.

(Items marked with * are required)

(*) Select One:*

Student

Faculty

Staff

Visitor

Patient

First Name:

Last Name:

(*) Email Address:*

An email confirmation of your submission will be sent to this address.

Telephone Number:

Nature of Concern (Please indicate all that apply)

(*) What does the issue involve? (Select all that apply)*

Building/Facility/Classroom Accessibility

Communication/Information

Services

Programs/Activities

Construction

Parking

Elevator

Other

Please provide the building name and the elevator number in the next section if selecting this option

(*) Please provide a description of the issues/barriers encountered. If possible include specific dates, locations, names and offices.*

Please describe any contacts made with University of Illinois Chicago representatives/offices regarding this issue

Optional Questions

I consider myself to have a disability or disabilities.

Yes

I have provided my contact information to be contacted regarding the reported issue.

Reporting of Accessibility Issues

Invalid Fields

Nature of Concern (Please indicate all that apply)

Optional Questions

Invalid Fields