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Access Barrier Form
Access Barrier Form
First Name
Last Name
E-Mail
Telephone Number
UVU Affiliation
Student
Faculty/Staff
Campus Visitor
Other
Type of Barrier?
Inoperative elevator/wheelchair lift
Inoperative accessible door
Blocked access ramp/accessible door
Inaccessible file/book/document
Inaccessible website/software/application
Refusal to make accessible accommodation
Other
Description of barrier:
Location of Barrier
Have you contacted anyone else about this barrier?
yes
no
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