Reporting of Accessibility Issues / New Form

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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.

(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 Question

I consider myself to have a disability or disabilities.

Yes

Reporting of Accessibility Issues

Invalid Fields

Nature of Concern (Please indicate all that apply)

Optional Question

Invalid Fields