Online version: This survey is also available online and can be completed on a mobile device or a computer. To complete the online version, visit ADA Checklist for Polling Places.
Disability Rights Texas would like to know if your polling place is accessible. Providing us information on the accessibility of your polling place may help resolve accessibility issues in the future. If you are interested in filling out this survey, please indicate the county and precinct information. You can also provide your contact information, although it is not required. Thank you!
Location & Contact Information
County: __________________________________________
Precinct: __________________________________________
Polling place address: ______________________________
Name (optional): ___________________________________
Phone/Email (optional): _____________________________
Parking
1. Was there at least one accessible parking space?
Select one: Yes No n/a
2. Was the accessible space marked by a visible sign (other than on the asphalt)?
Select one: Yes No n/a
3. Was the accessible parking area paved?
Select one: Yes No n/a
Entrance
4. Is the walkway from parking to accessible entrance free of steps?
Select one: Yes No n/a
5. If there are steps or curbs, are there ramps provided?
Select one: Yes No n/a
6. Was there at least one accessible entrance?
Select one: Yes No n/a
7. Could you open all doors with a closed fist?
Select one: Yes No n/a
8. Were all doors wide enough for a wheelchair to pass through (32 inches)?
Select one: Yes No n/a
Voting Area
9. Was there at least one accessible voting system provided?
Select one: Yes No n/a
10. Were you able to easily use the voting machine’s accessibility features?
Select one: Yes No n/a
If no, please explain: _________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
11. Were you able to cast your vote privately and independently?
Select one: Yes No n/a
12. If assistance or accommodations were requested, were poll workers helpful? (example: curbside voting, personal assistance, headphones)
Select one: Yes No n/a
If no, please explain: _________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
13. If your eligibility to vote was questioned, how did the poll worker handle the situation? __________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
14. Any other comments: _____________________________________________________
____________________________________________________________________________
____________________________________________________________________________
Please return this survey to:
HAVA Training and Technical Support Specialist
2222 West Braker Lane
Austin, TX 78758
Or email a scanned attachment to vote@development.disabilityrightstx.org
Or fax to: 512-323-0902
If you have questions about your voting rights, or want to report a violation, contact us on our Voting Rights Hotline at 1-888-796-VOTE (8683).
Last updated: March 2022
Publication Code: HA24
www.DRTx.org
Statewide Intake: 1-800-252-9108
Sign Language Video Phone: 1-866-362-2851
Purple 2 Video Phone: 512-271-9391
Online Intake available 24/7: intake.DRTx.org
Disclaimer: Disability Rights Texas strives to update its materials on an annual basis, and this handout is based upon the law at the time it was written. The law changes frequently and is subject to various interpretations by different courts. Future changes in the law may make some information in this handout inaccurate.
The handout is not intended to and does not replace an attorney’s advice or assistance based on your particular situation.
To request this handout in ASL, Braille, or as an audio file, contact us.
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