# Accessible product use feedback survey

Discover practical barriers in a product task without claiming compliance.

If nothing was unclear or difficult, say so. Skip questions about steps you did not experience; use not applicable where appropriate.

## 1. Which task was difficult to access or complete?

Answer: ____________________

## 2. Which control or instruction caused difficulty?

Answer: ____________________

## 3. What alternative interaction would help?

Answer: ____________________

## 4. Could you recover when a step did not work?

Answer: ____________________

## 5. How would you prefer to report an access need?

Answer: ____________________

## Author notes / illustrative keys where applicable

1. Task context identifies the practical outcome blocked by an access barrier. Preserve the affected step and conditions without asking for diagnoses or treating one response as a compliance assessment.
2. A specific control or instruction links a barrier to something the team can inspect. Check the interaction independently rather than attributing difficulty to the respondent's abilities.
3. Alternative interactions reveal ways to complete the same task when the current route fails. Evaluate the proposed method with affected users and technical checks; preference alone does not prove accessibility.
4. Recovery experiences show whether users remain blocked after a failed interaction. Inspect persistent instructions, focus and available alternatives rather than assuming the first successful route works for everyone.
5. Reporting preferences reveal whether the feedback route itself creates an access barrier. Offer an appropriate assisted or alternative channel without requiring respondents to disclose medical information.

Interpretation caution: Feedback is not an accessibility certification or a request for medical details.