The University of Illinois at Chicago is looking for health and fitness professionals who are employed at a fitness/recreation facility to complete an accessibility survey on their facility as a part of a national study. Facility staffs who participate in the study will have the option to receive feedback and advice on ways to further improve the accessibility of their facility.  

Complete the information below so that we can contact you with the materials for the study.

Completing this information only indicates that you are interested. You are free at any time to decide that you would no longer like to be a part of the study. All information will be kept confidential.

Name: *

Please type your name here.

Title:

Please type your job title here.

Email: *

Please type your email address here.

Phone Number: *

Please type your phone number here.

Name of Organization:

Please type the name of the organization you are a representative of.

Name of Facility:

Please type the name of the facility you wish to assess.

Location of Facility:

Please type the city and state the facility is located in.