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I had a difficult time voting at the following polling place:

Street Address:	(required)
Building Name:	(required)
City/Town:	(required)
County:	(required)
I had a difficult time voting for the reasons selected below.
Exterior access to the polling place was prohibitive due to:      a poorly or unlit parking space   a lack of accessible parking   a lack of access aisles   site access not being clearly marked   a lack of ramps or curb cuts   an unpaved parking space   available parking not closest route to building   no clear path of travel to the building   other:   explain: The building is not ADA compliant in the following areas:      steps   width of walkways   doors hinder or stop access   no elevators   no wheel chair ramps   ramp was too steep or no turn around space   no hand rails   no assistance available   accessible entrance not marked   no accessible entrance   entrance not near accessible parking   other:   explain: Poll workers...      were unaware of my special needs   refused to assist me   were not available to assist me   other:   explain: The voting booth...      signage was unclear or unreadable   was inaccessible   offered little or no privacy   Registration table incorrect height   did not have enough leg room   Lighting inadequate   other:   explain: The voting equipment...      was unusable   was confusing   had no audio   other:   explain: The sample ballot was...      confusing   unreadable   in the wrong language   different than the voting machine ballot   not made available in an alternate format   other:   explain: Contact Information: Name: (required) Street Address: (required)   City/Town: (required) Zip: (required) Telephone: e-mail: Additional Comments: