Product · free template

Accessibility Feedback Form

Structured reporting for accessibility barriers, capturing page, assistive technology used, severity and reply preference.

A ready-to-use technology, saas & dev form for engineering, IT and product teams: 13 questions, 3 pages, 4 conditional rules.

Questions: 13
Pages: 3
Layouts: classic · card
Conditional rules: 4
Typical time: 4 min

Preview it in the gallery

Searches this template answers

Also filed under

Access & audits

Live preview and test console

This is the real form. Answer it to test the 2 conditional rules — nothing is sent or stored.

Page 1 of 3 — The barrier

Every question on this page is currently visible.

What happens after submit: nothing is stored in this preview. On your own copy, every response triggers an instant email notification and lands in your response dashboard, ready to export or forward.

Happy with it? Take a copy into your workspace — every question, rule and setting comes with it.

Who this template is for

Accessibility Feedback Form is built for engineering, IT and product teams who need to route technical requests with the context needed to triage them.

Engineering, IT and product teams working in technology, saas & dev.
Teams who need to route technical requests with the context needed to triage them without writing code or paying for a custom build.
Anyone replacing vague reports that can't be reproduced or prioritised with one structured record per enquiry.
Respondents are users, testers and internal stakeholders — the form asks them 13 questions across 3 screens.
Mobile-heavy audiences, thanks to the one-question-per-screen card layout.

Why this form is useful

It removes the cost of vague reports that can't be reproduced or prioritised and turns each submission into a record your team can act on immediately.

7 questions are required, so submissions arrive complete instead of needing a follow-up email.
It collects a verified email address so replies and confirmations land.
It captures a phone number for urgent follow-up.
It accepts a document or photo upload as evidence.
It scores satisfaction on a consistent scale.
Conditional logic hides 4 questions until they are relevant — shorter forms convert better than long ones.
Splitting the form across 3 pages keeps each screen short and shows respondents how much is left.
Every response is stored, searchable and exportable, so nothing depends on one person's inbox.

How to use this template

From copy to live form is a few minutes of work, and every step is reversible.

1Press “Use this template” — a fresh copy of Accessibility Feedback Form lands in your workspace, ready to edit.
2Rename or delete any question, and change what is required. Nothing here is fixed.
3Open Notifications and add the email addresses that should be alerted on each submission; add an auto-reply to the respondent if the form collects an email address.
4Check the upload limits on the file question so respondents can attach what you actually need.
5Publish it, then either share the link directly or paste the embed snippet into your site — the embedded form resizes to fit and loads no marketing or advertising trackers.
6Watch responses land in Submissions, where you can filter, label and export them to CSV or PDF.

Logic and conditions blueprint

Exactly how this form behaves as it is answered — 4 conditional rules ship with it.

Features conditional validation: if “How would you like to be updated?” is By email, “Email address” becomes mandatory before the form can be sent.
Features conditional validation: if “How would you like to be updated?” is By phone, “Phone number” becomes mandatory before the form can be sent.
Features advanced show logic: if “Severity” is Completely blocks me from completing the task, the form dynamically exposes “What workaround, if any, did you use?”. Otherwise that question never appears.
Features advanced show logic: if “Assistive technology used” is Screen reader, the form dynamically exposes “Which screen reader and browser combination?”. Otherwise that question never appears.
All 4 rules are editable in the Logic tab, and the built-in checker warns about rules that contradict each other.

About this template

General bug reports rarely capture what an accessibility barrier actually needs fixed, because the details that matter — which assistive technology was in use, and exactly where the barrier occurred — are easy to leave out unless the form asks directly. This form starts with the page or feature URL and a description of what the person was trying to do, since accessibility issues are usually about a blocked task rather than a cosmetic defect. A dropdown captures the assistive technology in use, including screen readers, screen magnification, voice control and switch devices, because the fix for a screen-reader labelling issue is completely different from a fix for a low-contrast text issue. A barrier-type question sorts the report into categories like keyboard navigation, color contrast, missing labels or captions, and text alternatives, which routes it to the right part of the engineering or content team. A severity scale distinguishes a barrier that fully blocks a task from one that is merely inconvenient, so urgent blockers can be triaged ahead of minor ones. The closing question asks how the person would prefer to be contacted about the fix — email, phone or no reply needed — respecting that not everyone reporting a barrier wants an ongoing conversation about it.

What this form asks

Every question is editable — rename it, make it optional, or delete it entirely.

Page 1 — The barrier

Page or feature URLrequired
What were you trying to do?required
Barrier typerequired
Describe what happenedrequired

Page 2 — Assistive technology and severity

Assistive technology used
Which screen reader and browser combination?
Severity
Severityrequired
What workaround, if any, did you use?

Page 3 — Follow-up

How would you like to be updated?required
Email addressrequired
Phone number
Attach a screenshot or recording (optional)

13 questions in total.

How the form changes as it's filled in

This template ships with 4 conditional rules, grouped into 4 behaviours driven by 3 questions. Everything below is already set up — edit or delete any rule once the template is in your workspace.

Driven by “How would you like to be updated?”

Makes answers required
If “How would you like to be updated?” is By email, “Email address” becomes required before the form can be submitted.
Makes answers required
If “How would you like to be updated?” is By phone, “Phone number” becomes required before the form can be submitted.

Driven by “Severity”

Reveals questions
If “Severity” is Completely blocks me from completing the task, the form reveals “What workaround, if any, did you use?”.

Driven by “Assistive technology used”

Reveals questions
If “Assistive technology used” is Screen reader, the form reveals “Which screen reader and browser combination?”.

Set it up step by step

1
Triage by severity first, category second
A fully-blocking issue on a low-traffic page still outranks a minor issue on a checkout flow — sort on severity before routing by barrier type.
2
Route by barrier type to the right owner
Send contrast and labelling issues to design/content and keyboard or focus issues to engineering rather than a single shared queue.
3
Reproduce with the reported assistive technology
A fix verified only with a mouse and default browser settings often doesn't resolve the reported barrier — test with the same setup where possible.
4
Close the loop only when asked to
Respect the follow-up preference; reporters who chose 'no follow-up needed' should not be added to a support ticket thread.

Mistakes to avoid

Logging accessibility reports as generic bugs, losing the assistive-technology and barrier-type detail needed to reproduce them.
Deprioritizing every accessibility report equally instead of triaging by how much it blocks the task.
Contacting reporters who explicitly asked for no follow-up.

What it pairs with

Most teams don't run this form on its own. These are the forms and systems it sits next to.

Software Bug Report Form
Feature Request Submission Form
Incident Postmortem Form

What to do with the responses

Route by barrier type to the owning team, prioritise fully-blocking severity reports first, and reply only to reporters who requested follow-up.

Works in both layouts

Browse classic templates Browse card templates

Forms that overlap this one

These pages cover the same subject ground as the accessibility feedback form, matched on the words people actually search for.

Frequently asked questions

How is this different from the Software Bug Report Form?

A general bug report doesn't ask about assistive technology or barrier type. This form is built specifically to capture the detail an accessibility fix actually needs.

Do we need legal review before publishing this form?

This template only structures reporting; it makes no compliance claims, so review it against your own accessibility policy before publishing.

Should this be linked from every page?

Many teams link it from a persistent footer or accessibility statement page so it's discoverable without cluttering the main navigation.

What if the reporter doesn't know the technical terms?

The barrier-type and assistive-technology dropdowns include plain-language options, and the free-text 'what happened' field catches anything that doesn't fit neatly.

Is the Accessibility Feedback Form template free to use?

Yes. You can preview and test Accessibility Feedback Form on this page without an account, and take a copy into your own HelloForms workspace on the free plan. There is nothing to install and no card required to publish it.

What does the Accessibility Feedback Form template ask for?

It asks 13 questions across 3 pages, 7 of which are required. Every question is listed in full further down this page, and each one can be renamed, reordered, made optional or deleted after you copy the template.

Can I edit the Accessibility Feedback Form form after copying it?

Yes — the copy is entirely yours. Change wording, add or remove questions, switch between the classic and card layouts, restyle it to match your brand, and set who gets notified on each submission.

How does the conditional logic in this technology, saas & dev form work?

4 conditional rules ship with the template: Features conditional validation: if “How would you like to be updated?” is By email, “Email address” becomes mandatory before the form can be sent. Features conditional validation: if “How would you like to be updated?” is By phone, “Phone number” becomes mandatory before the form can be sent. Features advanced show logic: if “Severity” is Completely blocks me from completing the task, the form dynamically exposes “What workaround, if any, did you use?”. Otherwise that question never appears. All rules are editable in the Logic tab.

Where do responses to the Accessibility Feedback Form form go?

Submissions land in your workspace under Submissions, where you can search, filter, label and export them to CSV or PDF. You can also email a notification to your team on every submission and send the respondent an auto-reply.

Can I embed the Accessibility Feedback Form form on my own website?

Yes. Publish the form and paste the embed snippet into any page or share the direct link. The embedded form resizes to fit its container and loads no advertising or marketing trackers inside the iframe.

Can respondents upload files?

Yes. This template includes a file upload question, so respondents can attach documents or photos with their answers. You can adjust the accepted file types and size limits on that question.

More forms teams pair with the accessibility feedback form.

Related categories

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