Identify accessibility barriers in sessions using assistive tech. 7-10 min survey template exposes WCAG gaps. No personal data collected. Start now.
What's Included
AI-Powered Questions
Intelligent follow-up questions based on responses
Automated Analysis
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Detailed Reports
Comprehensive insights and recommendations
Template Overview
26
Questions
AI-Powered
Smart Analysis
Ready-to-Use
Launch in Minutes
This professionally designed survey template helps you gather valuable insights with intelligent question flow and automated analysis.
Sample Survey Items
Q1
Multiple Choice
Which type best describes the digital product you used most recently (past 14 days)?
Website on laptop/desktop
Website on phone/tablet browser
Native mobile app (iOS/Android)
Desktop application
Q2
Multiple Choice
Which assistive technologies did you use during that session? Select all that apply.
Screen reader
Screen magnifier/zoom
High contrast or custom colors
Voice control/dictation
Switch control
Keyboard-only navigation
Captions or transcripts
Read-aloud (not a full screen reader)
Alternative pointer (e.g., eye tracking, head mouse)
Other assistive tech
None of the above
Q3
Opinion Scale
In a typical month, how often do you use assistive technology for digital products?
Range: 1 – 10
Min: RarelyMid: About half the timeMax: Always
Q4
Rating
How clear and legible was the content (text, links, visuals) in that session?
Scale: 11 (star)
Min: Hard to see/readMax: Very clear and legible
Q5
Matrix
How easy or difficult was it to operate the interface with your setup?
Rows
Very difficult
Difficult
Neutral
Easy
Very easy
Not applicable
Navigate with keyboard only
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•
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•
Find headings or landmarks (structure)
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Operate forms (labels, errors)
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Activate menus and toggles
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Use a skip link or jump to main content
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•
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Dismiss pop-ups or overlays
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Q6
Matrix
Thinking about understanding and feedback, how was your experience?
Rows
Very difficult
Difficult
Neutral
Easy
Very easy
Not applicable
Link and button labels are specific
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Instructions appear before actions
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Error messages explain how to fix issues
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Icons also include visible text or labels
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Status or content changes are announced by assistive tech
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Q7
Multiple Choice
Which blockers did you encounter in that session? Select all that apply.
Low text contrast
Small or dense touch targets
Missing or poor alt text
No visible focus indicator
Keyboard traps
Unlabeled buttons or links
Ambiguous or missing error messages
Dynamic content not announced
CAPTCHA without an accessible alternative
Session timeouts too short
Motion/animation cannot be reduced
Other accessibility issue
None of the above
Q8
Long Text
Briefly describe the most significant blocker you faced. Include the page or feature if possible.
Max 600 chars
Q9
Rating
Overall, how much did blockers affect your ability to complete your goal?
Scale: 11 (star)
Min: No impactMax: Stopped me
Q10
Multiple Choice
Which tasks did you attempt in that session? Select all that apply.
Sign in or register
Search or browse content
Complete a form
Purchase or checkout
Upload or download files
Watch or listen to media
Change settings or preferences
Contact support or chat
Q11
Opinion Scale
How successfully did you complete your main task in that session?
Range: 1 – 10
Min: Not completedMid: Partly completedMax: Completed easily
Q12
Ranking
Rank these areas by priority for improvement for you (top = most important).
Drag to order (top = most important)
Visual clarity (contrast, size)
Keyboard/navigation reliability
Labels and alternative text
Error messages and guidance
Announcements of dynamic changes
Media accessibility (captions, transcripts)
Q13
Constant Sum
Distribute 100 points across the same improvement areas to reflect their value to you. Total must add to 100.
Total must equal 100
Min per option: 0Whole numbers only
Q14
Opinion Scale
Overall, how would you rate the accessibility of that session?
Range: 1 – 10
Min: Very poorMid: OkayMax: Excellent
Q15
Multiple Choice
Attention check: To confirm you are paying attention, please select "I am paying attention".
I am paying attention
I am not paying attention
Prefer not to say
Q16
Dropdown
What is your age group?
18–24
25–34
35–44
45–54
55–64
65+
Prefer not to say
Q17
Multiple Choice
How do you describe your gender?
Woman
Man
Non-binary
Prefer not to say
Q18
Short Text
Country or region you are based in:
Max 100 chars
Q19
Dropdown
What is the highest level of education you have completed?
Less than high school
High school or equivalent
Some college or vocational training
Bachelor’s degree
Graduate or professional degree
Prefer not to say
Q20
Multiple Choice
What is your current employment status?
Employed full-time
Employed part-time
Self-employed
Student
Unemployed
Retired
Prefer not to say
Q21
Multiple Choice
Which devices do you primarily use with assistive technology? Select all that apply.
Windows PC
Mac
Chromebook
iPhone/iPad (iOS/iPadOS)
Android phone/tablet
Other
Q22
Numeric
About how many years have you regularly used assistive technologies?
Accepts a numeric value
Whole numbers only
Q23
Chat Message
Welcome! Please answer based on your most recent session (in the past 14 days) using assistive technology.
Q24
Long Text
What single change would have most improved your experience?
Max 600 chars
Q25
AI Interview
AI Interview: 2 Follow-up Questions on your accessibility experience
AI InterviewLength: 2Personality: [Object Object]Mode: Fast
Q26
Chat Message
Thank you for your time—your feedback will help improve accessibility for everyone.
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