Inclusive Accessibility Consulting Survey

1

First Name* This field is required.

2

Last Name* This field is required.

3

Email* This field is required.

example@example.com

4

Name of Organization* This field is required.

5

Location of Organization* This field is required.Country & City

6

Please briefly describe your organization. * This field is required.Ex: Communal, Religious, Non-Profit, Communal, Entertainment, Tech, etc.

7

Which of these best describes your organization's disability accessibility goals?* This field is required.

We want to create a space where people with disabilities feel proud of who they are, disability included.

We want our employees and clients to openly use their mobility tools and feel comfortable asking for accommodations with confidence that they will be respected and honored.

We want to improve our building(s) physical accessibility for people with disabilities.

We want to improve our building(s) sensory accessibility for people with disabilities (includes audio/visual, mental health & neurodivergence).

We want to improve our web-accessibility, making our website and virtual programming fully accessible and user-friendly.

We want to improve our support for employees and clients on the disability spectrum.

We want expert advice for a specific project to ensure that we adhere to best practices in disability inclusion, accessibility and/or representation.

8

What do you think may be holding you back from reaching the goals you've indicated in the last question? Be as specific as possible!* This field is required.

9

How did you come to this booking form?* This field is required.

I spoke with Charlie via social media DM's.

I came to this form via a link in bio or Charlie's website.

I came to this form via referral.

10

Do you have any additional information or questions that you feel are important for Charlie to know? Please share them below.* This field is required.