First Name *
Last Name *
Email *
Phone Number *
The DATE and TIME that the accessibility concern was encountered.
The WEB PAGES(s) or WEB ADDRESS(es) where the accessibility concern was encountered.
The BROWSER (name and version) that was used when the accessibility concern was encountered.
The operating system on the device that was used when the accessibility concern was encountered.
Please provide a detailed description of the accessibility concern.
If applicable, kindly share the assistive technology/technologies that was/were in use when the accessibility concern was encountered.
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