ADA Compliance Website Audit Request

ADA Compliance Website Audit Request — Form Fields

This legal template includes 15 fields. Request form for businesses seeking ADA/WCAG compliance audits of their websites. Free to customize and use on ZenBuild.

• Business Name (text, required)
• Contact Person (text, required)
• Email (email, required)
• Phone Number (text, required)
• Website URL (text, required)
• Website Type (dropdown selection, required) — options: E-Commerce, Informational, SaaS Application, Government, Education, Healthcare, Financial Services, Nonprofit
• Current WCAG Compliance Level (dropdown selection, required) — options: Unknown, Not Compliant, Partial (Level A), Level A, Level AA, Level AAA
• Received ADA Demand Letter (multiple choice, required) — options: Yes, No
• Currently in Litigation (multiple choice, required) — options: Yes, No
• Audit Scope (dropdown selection, required) — options: Full Website, Specific Pages, Mobile App, Both Website and App
• Approximate Number of Pages (number, optional)
• Timeline (dropdown selection, required) — options: Emergency (demand letter received), Urgent (within 1 week), Standard (2-4 weeks), Planning Phase
• Budget Range (dropdown selection, optional) — options: Under $2500, $2500-$5000, $5000-$10000, $10000-$25000, Over $25000
• Services Needed (checkboxes, optional) — options: Automated Scan, Manual Testing, Screen Reader Testing, VPAT/ACR Report, Remediation Plan, Ongoing Monitoring
• Additional Context (long text, optional)