Accessibility Incident Report

Accessibility Incident Report Form

This form is designed to allow students with disabilities to submit complaints and reports. Reports are submitted to the exclusively to the Vice President Student Affairs, and will be shared with the Accessibility Director at their discretion. Your anonymity is guaranteed.

Name
First Last
Email
Student Number
Incident Location
Where did the incident take place? Please try to be as accurate as possible.
Please elaborate if selected "other."
Type of Complaint*
Please elaborate if selected "other."
Short Description of Incident*
Please try to give as many details as possible.
Estimated Date of Incident
MM slash DD slash YYYY

Please try to be as accurate as possible.
Further Documentation (if any).
Max. file size: 100 MB.
Pictures, screenshots, documentation etc.
Would you like us to follow up about this incident?*

The UWSA is committed to protecting personal information provided in the course of the services it provides and the operation of the organization, including that information submitted in the forms. For more information please see the UWSA Privacy Policy, available online here, and last revised in 2019.