Report a Facility Access Barrier

Please fill out this form to report a facility access barrier at UCCS.

*First Name:

*Last Name:

*Phone:

*E-mail Address:

*Affiliation with the University



Describe the accessibility barrier (please be specific)

*Building Name:

*Building # / Location:

*Specific Area/ Room Number (Enter Location and Description of Problem:

Person to whom initial report was made
*Name:

*Position:

Phone:

E-mail Address:
Other Contact

*Have you made any other contacts to try to rectify the problem?



Name:

Position:

Phone:



* denotes required field